Morbidity and mortality after minor bile duct injury following laparoscopic cholecystectomy
| Autor: | Kenneth Yap, Susan van Dieren, Erik A.J. Rauws, Otto M. van Delden, Klaske A. C. Booij, D. J. Gouma, Philip R. de Reuver |
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| Přispěvatelé: | Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Graduate School, Plastic, Reconstructive and Hand Surgery, Amsterdam Public Health, Surgery, Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Gastroenterology and Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Kaplan-Meier Estimate Postoperative Complications Risk Factors Risk of mortality medicine Humans Endoscopic stenting Aged Proportional Hazards Models Retrospective Studies Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Bile duct Hazard ratio Cystic Duct Gastroenterology Retrospective cohort study Middle Aged Surgery Treatment Outcome medicine.anatomical_structure Cholecystectomy Laparoscopic Cystic duct Female Cholecystectomy Bile Ducts business Follow-Up Studies |
| Zdroj: | Endoscopy, 47(1), 40-46. Georg Thieme Verlag |
| ISSN: | 0013-726X |
| DOI: | 10.1055/s-0034-1390908 |
| Popis: | Background and study aims: Cystic duct and Luschka duct leakage after laparoscopic cholecystectomy are often classified as minor injuries because the outcome of endoscopic stenting and percutaneous drainage is generally reported to be good. However, the potential associated early mortality and risk factors for mortality are scarcely reported. The aim of this study was to describe the outcome, mortality, and risk factors for poor survival of patients with type A bile duct injury (BDI) referred to a tertiary center. Patients and methods: Between January 1990 and January 2012, 800 patients were referred for BDI treatment and included in a prospective database. Results: Type A BDI, according to the Amsterdam and Strasberg classifications, was diagnosed in 216 patients. Treatment after referral was mainly endoscopic (n = 192 [88.9 %]) and radiologic (n = 14 [6.5 %]). Complications related to endoscopic retrograde cholangiopancreatography (ERCP) occurred in 14 patients (6.5 %). Other complications were sepsis (n = 34 [15.7 %]), cardiopulmonary (n = 22 [10.2 %]), and abscess formation (n = 15 [6.9 %]). BDI-related mortality was 4.2 % (9/216). Multivariate analysis showed age (hazard ratio [HR] = 1.04, 95 % confidence interval [CI] 1.00 – 1.07) and American Society of Anesthesiologists class 3 or 4 (HR = 5.64, 95 %CI 2.31 – 13.77) to be independent factors significantly associated with mortality. Conclusions: Type A “minor” BDI after laparoscopic cholecystectomy is associated with considerable short-term mortality related to the patient’s condition at referral. Older patients and patients with ASA 3 or 4 have a significantly higher risk of mortality. |
| Databáze: | OpenAIRE |
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