Risk Factors for Cholangitis After Pancreatoduodenectomy: A Systematic Review.

Autor: Salaheddine Y; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., Henry AC; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., Daamen LA; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., Derksen WJM; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., van Lienden KP; Department of Radiology, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., Molenaar IQ; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., van Santvoort HC; Department of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Utrecht, The Netherlands., Vleggaar FP; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Verdonk RC; Department of Gastroenterology & Hepatology, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands. r.verdonk@antoniusziekenhuis.nl.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2023 Jul; Vol. 68 (7), pp. 3158-3166. Date of Electronic Publication: 2023 Apr 06.
DOI: 10.1007/s10620-023-07929-x
Abstrakt: Background: Cholangitis is a late complication after pancreatoduodenectomy with considerable clinical impact and is difficult to treat. The aim of this systematic review was to provide an overview of the literature identifying risk factors for postoperative cholangitis.
Methods: A systematic search of the databases PUBMED and EMBASE was performed to identify all studies reporting on possible risk factors for cholangitis following pancreatoduodenectomy. Data on patient, peri- and postoperative characteristics were collected. Risk of bias assessment was done according to the methodological index for non-randomized studies (MINORS) criteria.
Results: In total, 464 studies were identified. Eight studies met the inclusion criteria for this analysis. The definition of postoperative cholangitis was inconsistent, with four studies using the Tokyo Guidelines, whereas other studies used different definitions. Data on 26 potential risk factors concerning the patient, peri- and postoperative characteristics were analyzed. Five factors were significantly associated with cholangitis in two or more studies: high body mass index, duration of surgery, benign disease, postoperative pancreatic fistula, and postoperative serum alkaline phosphatase.
Conclusion: Multiple potential risk factors for postoperative cholangitis were identified, with large discrepancies between studies. Prospective research, with consensus on the definition, is required to determine the true relevance of these risk factors.
(© 2023. The Author(s).)
Databáze: MEDLINE
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