Clinically relevant late-onset biliary complications after pancreatoduodenectomy

Citation:

Minako Nagai, Nakagawa, Kenji , Nishiwada, Satoshi , Terai, Taichi , Hokuto, Daisuke , Yasuda, Satoshi , Matsuo, Yasuko , Doi, Shunsuke , Akahori, Takahiro , ו Sho, Masayuki . 2022. “Clinically Relevant Late-Onset Biliary Complications After Pancreatoduodenectomy”. World J. Surg., 46, 6, Pp. 1465–1473.

תקציר:

BACKGROUND: Late-onset biliary complications (LBC) after pancreatoduodenectomy (PD) can be serious. This study aimed to clarify the frequency and risk factors of severe LBC after PD. METHODS: We defined LBC as biliary complications occurring 3 months after PD and severe LBC as cases that required intensive care. A total of 318 patients who underwent PD between 2010 and 2018 with at least 1 year of postoperative follow-up were evaluated. RESULTS: Hospitalization for severe LBC was required in 59 patients (19%), of whom 20 had liver abscesses (6.3%); 18, acute cholangitis (5.7%); 12, biliary stones (3.8%); and 21, biliary strictures (6.6%). Interventional radiological or endoscopic treatment was required in 32 patients (10%), of whom 9 had a benign primary disease with biliary stones and/or strictures. Thirteen of the remaining 23 patients with a malignant primary disease had liver abscesses and cholangitis. Significant independent risk factors for severe LBC in patients with malignant primary disease were recurrence around the hepaticojejunostomy (odds ratio 6.