Predictors of outcome after reconstructive hepaticojejunostomy for post cholecystectomy bile duct injuries

Gomes, Rachel M.

doi:10.7869/tg.296

Cited by 9 publications

(10 citation statements)

References 19 publications

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“…Although there is ongoing debate as to whether VBI influences outcome, a number of studies have documented the negative impact of VBI on the postoperative course [27] , [28] . In this study, the prevalence of VBI was similar to previously published studies [18] , [29] . Notably, however, no VBIs were identified pre-operatively in patients treated in the early period when there was limited access to and poorer quality of cross sectional imaging.…”

Section: Discussionsupporting

confidence: 92%

“…In some, an injury above the hepatic duct bifurcation was a predictor of poor outcome [15] , [16] . In others, no correlation between severity of injury and long-term outcome was found [17] , [18] . We analyzed the correlation between the severity of injury according to the ATOM classification and the risk of postoperative complications as assessed by the Modified Accordion Grading System (MAGS) in a large cohort of patients after biliary reconstruction of major BDI at a tertiary referral center [14] , [19] .…”

Section: Introductionmentioning

confidence: 96%

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An analysis of early postoperative complications following biliary reconstruction of major bile duct injuries using the Modified Accordion and Anatomic, Timing Of and Mechanism classifications

Lindemann

Jonas

Kotze

2019

Surgery Open Science

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Background Few studies have reported patient outcome after surgical repair of bile duct injury using a standardized, validated classification system. This is the first analysis to investigate the correlation between the Anatomic, Timing Of and Mechanism classification of bile duct injury and severity of postoperative complications classified using the Modified Accordion Grading System. Methods Patients undergoing index hepaticojejunostomy repair of bile duct injury in laparoscopic cholecystectomy at a tertiary referral center from 1993-2018 were included. Patient demographics, geographic distance from referral center, time to referral, Anatomic, Timing Of and Mechanism classification and highest Modified Accordion Grade complication were retrieved from a prospective database. The primary outcome was determined using correlation statistics to assess the relationship between level of injury and severity of postoperative complication. Results One hundred and twenty-eight patients were included. There was no correlation between level of injury and severity of postoperative complication ( r s (128) = –0.113, P = .203). Seventy (54.7%) patients had an injury less than 2 cm from the hepatic duct bifurcation and 52% of patients developed a postoperative complication, most mild to moderate in severity. Geographic distance resulted in substantial delays in referral (P < .001) but did not affect complication rate (P = .523). Conclusion In this prospective analysis the short-term complication rate was higher than previous retrospective reports, but the distribution of the severity of complications and spectrum of injury type were similar. There was no correlation between severity of injury and postoperative complications. Geographic distance from referral center resulted in substantial differences in referral delay but had no statistically significant effect on outcome.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 96%

An analysis of early postoperative complications following biliary reconstruction of major bile duct injuries using the Modified Accordion and Anatomic, Timing Of and Mechanism classifications

Lindemann

Jonas

Kotze

2019

Surgery Open Science

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“…Die frühest mögliche Überweisung in ein erfahrenes hepatobiliäres Zentrum ist ein Prädiktor für das Outcome [8]. Auch bei optimaler Versorgung mit Rekonstruktion und nachfolgend unkompliziertem Verlauf können langfristige Auswirkungen wie eine rezidivierende Cholangitis und sogar mentale Einschränkungen der gesundheitsbezogenen Lebensqualität nicht ausgeschlossen werden [9].…”

Section: H Dralle Essen; K Kols Hannoverunclassified

Intraoperativ nicht erkannte zentrale Gallenwegsverletzung

Dralle

Kols

Weimann

et al. 2017

Chirurg

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“…3 Advances in therapeutic endoscopy have led to endoscopic management replacing surgical repair as the standard of care. 4, 5…”

Section: Introductionmentioning

confidence: 99%

Liver transplant–related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach

Barakat

Huang

Thosani

et al. 2018

Gastrointestinal Endoscopy

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Predictors of outcome after reconstructive hepaticojejunostomy for post cholecystectomy bile duct injuries

Abstract: Introduction: Reconstructive hepatico-jejunostomy is recommended for major bile duct injuries (BDIs) during cholecystectomy. Complications of biliary leak, cholangitis, bleeding, anastomotic

Cited by 9 publications

References 19 publications

An analysis of early postoperative complications following biliary reconstruction of major bile duct injuries using the Modified Accordion and Anatomic, Timing Of and Mechanism classifications

An analysis of early postoperative complications following biliary reconstruction of major bile duct injuries using the Modified Accordion and Anatomic, Timing Of and Mechanism classifications

Intraoperativ nicht erkannte zentrale Gallenwegsverletzung

Liver transplant–related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach

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