Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy - an E-AHPBA multi-center study

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dc.contributor.authorRystedt, Jenny M. L.
dc.contributor.authorKleeff, Joerg
dc.contributor.authorSalvia, Roberto
dc.contributor.authorBesselink, Mark G.
dc.contributor.authorPrasad, Raj
dc.contributor.authorLesurtel, Mickael
dc.contributor.authorCoker, A.
dc.date.accessioned2020-12-01T12:06:07Z
dc.date.available2020-12-01T12:06:07Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description13th World Biennial Congress of the International-Hepato-Pancreato-Biliary-Association (IHPBA) -- SEP 04-07, 2018 -- Geneva, SWITZERLANDen_US
dc.descriptionArdito, Francesco/0000-0003-1596-2862; PESCE, ANTONIO MD/0000-0002-7560-551X; Gallagher, Tom/0000-0002-5765-2574; Bernon, Marc/0000-0002-7967-8548; Stattner, Stefan/0000-0002-5226-7597; GIULIANTE, FELICE/0000-0003-2087-2589; Omoshoro-Jones, Jones A. O./0000-0002-1071-298X; de Rose, Agostino Maria/0000-0003-3310-8088; Abu Hilal, Mohammed/0000-0002-3162-4639; Kleeff, Jorg/0000-0003-3432-6669; Prieto, Mikel/0000-0001-6662-4252; Stromberg, Cecilia/0000-0003-0843-7920en_US
dc.description.abstractBackground: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. the aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0-7), intermediate (1-6 weeks) and late (6 weeks-6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: in total 913 patients from 48 centers were included in the analysis. in 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. in multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. the rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37-8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable.en_US
dc.description.sponsorshipInt Hepato Pancreato Biliary Assocen_US
dc.identifier.doi10.1016/j.hpb.2019.04.003en_US
dc.identifier.endpage1647en_US
dc.identifier.issn1365-182X
dc.identifier.issn1477-2574
dc.identifier.issue12en_US
dc.identifier.pmid31151812en_US
dc.identifier.startpage1641en_US
dc.identifier.urihttps://doi.org/10.1016/j.hpb.2019.04.003
dc.identifier.urihttps://hdl.handle.net/11454/63159
dc.identifier.volume21en_US
dc.identifier.wosWOS:000500283700006en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofHpben_US
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.titlePost cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy - an E-AHPBA multi-center studyen_US
dc.typeConference Objecten_US

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