Long-term outcomes of delayed biliary strictures following cholecystectomy. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Halle-Smith, James M.; Marudanayagam, Ravi; Mirza, Darius F.; Roberts, Keith J.
• Is Part Of: HPB. Volume 24:Issue 2(2022)
• Page Start: 209
• Page End: 216
• Publication Date: 2022-02
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2021.06.416
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Delayed biliary strictures (DBS) after cholecystectomy are uncommon and little is known of their aetiology or long-term consequences. The aims of this study were to investigate the clinical and economic impact of DBS after cholecystectomy. Methods: Patients who developed DBS after cholecystectomy were identified from a prospectively collected and maintained database. Risk factors for stricture development, quality of life (QoL) and long-term biliary complication rates were explored. Costs of treatment and follow up were determined. The same outcomes among patients with minor or major bile duct injury (BDI) were used as a comparison. Results: Among 44 patients, a laparoscopic converted to open procedure or post cholecystectomy bile leak affected some 18 and 12 patients respectively. Most DBS required surgical treatment (40). Over a median follow-up of 8.9 years after DBS treatment, 16 (36%) patients developed biliary complications (similar to minor, 26%, and major BDI, 40%) and 1 patient died of causes related to the biliary stricture. Costs of treating DBS and its follow up (£14, 309.26 per patient), were similar to previously reported costs for major BDI (£15, 784). Conclusion: DBS typically occur after a technically and/or complicated cholecystectomy. Clinical, economic and QoL outcomes are similar to patients with major BDI.