Long‐term outcome after early repair of iatrogenic bile duct injury. A national Danish multicentre study. Issue 5 (12th January 2015)

• Record Type: Journal Article
• Authors: Stilling, Nicolaj M.; Fristrup, Claus; Wettergren, André; Ugianskis, Arnas; Nygaard, Jacob; Holte, Kathrine; Bardram, Linda; Sall, Mogens; Mortensen, Michael B.
• Is Part Of: HPB. Volume 17:Issue 5(2015:May)
• Page Start: 394
• Page End: 400
• Publication Date: 2015-01-12
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12374
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12374-sec-0001" sec-type="section"> <title>Background</title> <p>The aim of this retrospective study was to evaluate the peri‐operative and long‐term outcome after early repair with a hepaticojejunostomy (HJ).</p> </sec> <sec id="hpb12374-sec-0002" sec-type="section"> <title>Methods</title> <p>Between 1995 and 2010, a nationwide, retrospective multi‐centre study was conducted. All iatrogenic bile duct injury (BDI) sustained during a cholecystectomy and repaired with HJ in the five Hepato‐Pancreatico‐Biliary centres in Denmark were included.</p> </sec> <sec id="hpb12374-sec-0003" sec-type="section"> <title>Results</title> <p>In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19%). Post‐operative morbidity was 36% and mortality was 4%. Forty‐two patients (30%) had a stricture of the HJ. The median follow‐up time without stricture was 102 months. Nineteen out of the 42 patients with post‐reconstruction biliary strictures had a re‐HJ. Twenty‐three patients were managed with percutaneous transhepatic cholangiography and dilation. The overall success rate of re‐establishing the biliodigestive flow approached 93%. No association was found between timing of repair, concomitant vascular injury, level of injury and stricture formation.</p> </sec> <sec id="hpb12374-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In this national, unselected and consecutive cohort of patients with BDI repaired by early HJ we found a considerable risk of long‐term complications (e.g. 30% stricture rate) and mortality in both the short‐ and the long‐term perspective.</p> </sec> </abstract>