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Langenbeck's Archives of Surgery

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01-11-2020 | Cholecystectomy | Original Article

Factors associated with patency loss and actuarial patency rate following post-cholecystectomy bile duct injury repair: long-term follow-up

Authors: Gustavo Martínez-Mier, Pedro I. Moreno-Ley, Daniel Mendez-Rico

Published in: Langenbeck's Archives of Surgery | Issue 7/2020

Abstract

Purpose

Several factors may contribute to bile duct injury (BDI) repair failure. The objective of our study was to evaluate factors that contribute to the loss of patency and influence the actuarial patency rate of BDI repairs in an 11-year period.

Methods

Retrospective review study of patients who underwent a hepaticojejunostomy for a type E Bismuth-Strasberg BDI (2008-2019). The outcomes are the following: primary patency attained, loss of primary patency, and actuarial primary patency rate. Logistic regression for loss of patency and Cox regression for actuarial patency rate were used.

Results

Seventy-nine patients (age 42.3 ± 15.8 years, 81% female) were studied. Most common index operation was open cholecystectomy (60.8%). Most common Bismuth-Strasberg lesion was E4 (38%). Primary patency was 93.4%. Mean follow-up was 36 ± 34 months. Ten-year actuarial patency was 53.9%. Factors associated with loss of patency were vasculobiliary injury, biliary stents, and 90-day biliary complications (univariate); number of surgeries before repair and postoperative cholangitis (univariate and multivariate) (p < 0.05). Factors that impacted actuarial patency rate were (univariate analysis) 90-day biliary complications; postoperative cholangitis and index treatment period stenosis (p < 0.05). No factors impacted actuarial patency rate in multivariate analysis.

Conclusion

Postoperative cholangitis is associated with loss of patency and had potentially detrimental effect on the actuarial patency rate in BDI repair.

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Title: Factors associated with patency loss and actuarial patency rate following post-cholecystectomy bile duct injury repair: long-term follow-up
Authors: Gustavo Martínez-Mier
Pedro I. Moreno-Ley
Daniel Mendez-Rico
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Cholecystectomy
Cholangitis
Published in: Langenbeck's Archives of Surgery / Issue 7/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01984-y

At a glance: The STEP trials

Springer Medicine

Factors associated with patency loss and actuarial patency rate following post-cholecystectomy bile duct injury repair: long-term follow-up

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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