Undiagnosed Liver Fibrosis in Patients Undergoing Pancreatoduodenectomy for Pancreatic Adenocarcinoma
Autor: | D.R. Jeyarajah, Steve Foster, Andrew Gdowski, Umar Butt, Houssam Osman |
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Rok vydání: | 2017 |
Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty medicine.medical_treatment Bile obstruction Adenocarcinoma Gastroenterology Pancreaticoduodenectomy 03 medical and health sciences 0302 clinical medicine Cholestasis Internal medicine Biopsy medicine Humans Aged Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study Middle Aged medicine.disease Pancreatic Neoplasms Exact test 030220 oncology & carcinogenesis Female Stents 030211 gastroenterology & hepatology Surgery business Hepatic fibrosis Abdominal surgery |
Zdroj: | World Journal of Surgery. 41:2854-2857 |
ISSN: | 1432-2323 0364-2313 |
Popis: | Chronic obstruction of the biliary system may cause hepatic fibrosis and liver failure. The purpose of this study was to define the incidence of unrecognized liver fibrosis in patients undergoing pancreaticoduodenectomy (PD). Retrospective data were collected on patients undergoing PD during a 21-month period. Each patient had a core needle biopsy at the time of surgery by a hepatobiliary surgeon. This study identified 36 consecutive patients who were referred to a tertiary center and underwent pancreatoduodenectomy during a period of 21 months. The majority of patients, 32 (88.8%), were diagnosed with pancreatic adenocarcinoma. Liver fibrosis was diagnosed in 23 (63.9%) patients. A total of 25 (69.4%) patients were found to have pathological evidence of cholestasis consistent with bile obstruction. Patients that were found to have evidence of obstruction had significantly increased odds that fibrosis stage 2 would be found on pathological diagnosis (OR 6.75, 95% CI 1.20–38.02, Fisher’s exact test P value = 0.0312). There was no significant association in patients who were stented compared to non-stented patients and their diagnosis of high-grade fibrosis stage 2 (OR 1.5238, 95% CI 0.4019–5.7769, Fisher’s exact test P value = 0.7360). An astonishing 63.9% of patients who underwent PD were diagnosed with stage 1–4 liver fibrosis and half (47.2%) had fibrosis stage of 2 or more. Further, stent status had no significant impact on the degree of liver fibrosis. Liver fibrosis is currently underrecognized in patients undergoing PD, which is important for physicians to be conscious of as it is known that liver fibrosis increases morbidity and mortality. |
Databáze: | OpenAIRE |
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