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Erschienen in: Journal of Gastrointestinal Surgery 4/2018

22.12.2017 | Original Article

Incidence and Risk Factors of Cholangitis after Hepaticojejunostomy

verfasst von: Takehiro Okabayashi, Yasuo Shima, Tatsuaki Sumiyoshi, Kenta Sui, Jun Iwata, Sojiro Morita, Tatsuo Iiyama, Yasuhiro Shimada

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2018

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Abstract

Background

After hepatobiliary-pancreatic surgery, hepaticojejunostomy cholangitis is a rare condition; the true incidence rate of postoperative cholangitis is unknown. Therefore, our study aimed to determine the incidence rate and timing of postoperative cholangitis after biliary-enteric anastomosis, and to evaluate risk factors and management strategies.

Methods

Our single-center retrospective study included 583 patients who had undergone biliary-enteric anastomosis for hepatobiliary-pancreatic diseases. Demographic and treatment data were extracted from the medical records, and the association between potential risk factors and the development of postoperative cholangitis evaluated using a prospectively collected database.

Results

Postoperative cholangitis developed in 45/583 patients (incidence rate, 7.7%), on average 18.3 ± 27.4 months (median = 6.9 months) after surgery. On multivariate analysis, the following factors were independently associated with postoperative cholangitis after biliary-enteric anastomosis: male sex, benign condition, and postoperative complication with a Clavien-Dindo classification grade > III. Among patients with postoperative cholangitis, a biliary stricture developed in 57.8% (26/45) of cases. Percutaneous balloon dilatation (73.1%) and endoscopic stenting (11.5%) were used as initial treatment of the stricture, with surgical revision being required in only 15.4% of cases of hepaticojejunostomy stricture.

Conclusion

Biliary-enteric anastomotic cholangitis after hepaticojejunostomy is a distinct disease process. Although non-operative management of postoperative cholangitis is successful in many cases, further research is required to better understand patient- and physician-related factors that predispose patients to postoperative cholangitis.
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Metadaten
Titel
Incidence and Risk Factors of Cholangitis after Hepaticojejunostomy
verfasst von
Takehiro Okabayashi
Yasuo Shima
Tatsuaki Sumiyoshi
Kenta Sui
Jun Iwata
Sojiro Morita
Tatsuo Iiyama
Yasuhiro Shimada
Publikationsdatum
22.12.2017
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2018
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-017-3532-9

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