Long-term outcomes of delayed biliary strictures following cholecystectomy
| Autor: | Ravi Marudanayagam, Keith J. Roberts, James M. Halle-Smith, Darius F. Mirza |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Biliary complication Constriction Pathologic 030230 surgery behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine Quality of life medicine Long term outcomes Humans Cholecystectomy Surgical treatment Bile leak Cholestasis Hepatology Bile duct business.industry Gastroenterology Surgery medicine.anatomical_structure Cholecystectomy Laparoscopic 030220 oncology & carcinogenesis Quality of Life Etiology Bile Ducts business |
| Zdroj: | HPB. 24:209-216 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2021.06.416 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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