Long-term outcome after early repair of iatrogenic bile duct injury: A national Danish multicentre study

Nicolaj M Stilling, Claus Fristrup, André Wettergren, Arnas Ugianskis, Jacob Nygaard, Kathrine Holte, Linda Bardram, Mogens Sall, Michael B Mortensen

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    BACKGROUND: The aim of this retrospective study was to evaluate the peri-operative and long-term outcome after early repair with a hepaticojejunostomy (HJ).

    METHODS: Between 1995 and 2010, a nationwide, retrospective multi-centre study was conducted. All iatrogenic bile duct injury (BDI) sustained during a cholecystectomy and repaired with HJ in the five Hepato-Pancreatico-Biliary centres in Denmark were included.

    RESULTS: In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19%). Post-operative morbidity was 36% and mortality was 4%. Forty-two patients (30%) had a stricture of the HJ. The median follow-up time without stricture was 102 months. Nineteen out of the 42 patients with post-reconstruction biliary strictures had a re-HJ. Twenty-three patients were managed with percutaneous transhepatic cholangiography and dilation. The overall success rate of re-establishing the biliodigestive flow approached 93%. No association was found between timing of repair, concomitant vascular injury, level of injury and stricture formation.

    CONCLUSION: In this national, unselected and consecutive cohort of patients with BDI repaired by early HJ we found a considerable risk of long-term complications (e.g. 30% stricture rate) and mortality in both the short- and the long-term perspective.

    OriginalsprogEngelsk
    TidsskriftH P B
    Vol/bind17
    Udgave nummer5
    Sider (fra-til)394-400
    ISSN1365-182X
    DOI
    StatusUdgivet - 2015

    Fingeraftryk

    Multicenter Studies
    Pathologic Constriction
    Wounds and Injuries
    Vascular System Injuries
    Cholangiography
    Denmark
    Dilatation
    Retrospective Studies

    Citer dette

    Stilling, Nicolaj M ; Fristrup, Claus ; Wettergren, André ; Ugianskis, Arnas ; Nygaard, Jacob ; Holte, Kathrine ; Bardram, Linda ; Sall, Mogens ; Mortensen, Michael B. / Long-term outcome after early repair of iatrogenic bile duct injury : A national Danish multicentre study. I: H P B. 2015 ; Bind 17, Nr. 5. s. 394-400.
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    title = "Long-term outcome after early repair of iatrogenic bile duct injury: A national Danish multicentre study",
    abstract = "BACKGROUND: The aim of this retrospective study was to evaluate the peri-operative and long-term outcome after early repair with a hepaticojejunostomy (HJ).METHODS: Between 1995 and 2010, a nationwide, retrospective multi-centre study was conducted. All iatrogenic bile duct injury (BDI) sustained during a cholecystectomy and repaired with HJ in the five Hepato-Pancreatico-Biliary centres in Denmark were included.RESULTS: In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19{\%}). Post-operative morbidity was 36{\%} and mortality was 4{\%}. Forty-two patients (30{\%}) had a stricture of the HJ. The median follow-up time without stricture was 102 months. Nineteen out of the 42 patients with post-reconstruction biliary strictures had a re-HJ. Twenty-three patients were managed with percutaneous transhepatic cholangiography and dilation. The overall success rate of re-establishing the biliodigestive flow approached 93{\%}. No association was found between timing of repair, concomitant vascular injury, level of injury and stricture formation.CONCLUSION: In this national, unselected and consecutive cohort of patients with BDI repaired by early HJ we found a considerable risk of long-term complications (e.g. 30{\%} stricture rate) and mortality in both the short- and the long-term perspective.",
    author = "Stilling, {Nicolaj M} and Claus Fristrup and Andr{\'e} Wettergren and Arnas Ugianskis and Jacob Nygaard and Kathrine Holte and Linda Bardram and Mogens Sall and Mortensen, {Michael B}",
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    doi = "10.1111/hpb.12374",
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    pages = "394--400",
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    Stilling, NM, Fristrup, C, Wettergren, A, Ugianskis, A, Nygaard, J, Holte, K, Bardram, L, Sall, M & Mortensen, MB 2015, 'Long-term outcome after early repair of iatrogenic bile duct injury: A national Danish multicentre study', H P B, bind 17, nr. 5, s. 394-400. https://doi.org/10.1111/hpb.12374

    Long-term outcome after early repair of iatrogenic bile duct injury : A national Danish multicentre study. / Stilling, Nicolaj M; Fristrup, Claus; Wettergren, André; Ugianskis, Arnas; Nygaard, Jacob; Holte, Kathrine; Bardram, Linda; Sall, Mogens; Mortensen, Michael B.

    I: H P B, Bind 17, Nr. 5, 2015, s. 394-400.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Long-term outcome after early repair of iatrogenic bile duct injury

    T2 - A national Danish multicentre study

    AU - Stilling, Nicolaj M

    AU - Fristrup, Claus

    AU - Wettergren, André

    AU - Ugianskis, Arnas

    AU - Nygaard, Jacob

    AU - Holte, Kathrine

    AU - Bardram, Linda

    AU - Sall, Mogens

    AU - Mortensen, Michael B

    N1 - © 2015 International Hepato-Pancreato-Biliary Association.

    PY - 2015

    Y1 - 2015

    N2 - BACKGROUND: The aim of this retrospective study was to evaluate the peri-operative and long-term outcome after early repair with a hepaticojejunostomy (HJ).METHODS: Between 1995 and 2010, a nationwide, retrospective multi-centre study was conducted. All iatrogenic bile duct injury (BDI) sustained during a cholecystectomy and repaired with HJ in the five Hepato-Pancreatico-Biliary centres in Denmark were included.RESULTS: In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19%). Post-operative morbidity was 36% and mortality was 4%. Forty-two patients (30%) had a stricture of the HJ. The median follow-up time without stricture was 102 months. Nineteen out of the 42 patients with post-reconstruction biliary strictures had a re-HJ. Twenty-three patients were managed with percutaneous transhepatic cholangiography and dilation. The overall success rate of re-establishing the biliodigestive flow approached 93%. No association was found between timing of repair, concomitant vascular injury, level of injury and stricture formation.CONCLUSION: In this national, unselected and consecutive cohort of patients with BDI repaired by early HJ we found a considerable risk of long-term complications (e.g. 30% stricture rate) and mortality in both the short- and the long-term perspective.

    AB - BACKGROUND: The aim of this retrospective study was to evaluate the peri-operative and long-term outcome after early repair with a hepaticojejunostomy (HJ).METHODS: Between 1995 and 2010, a nationwide, retrospective multi-centre study was conducted. All iatrogenic bile duct injury (BDI) sustained during a cholecystectomy and repaired with HJ in the five Hepato-Pancreatico-Biliary centres in Denmark were included.RESULTS: In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19%). Post-operative morbidity was 36% and mortality was 4%. Forty-two patients (30%) had a stricture of the HJ. The median follow-up time without stricture was 102 months. Nineteen out of the 42 patients with post-reconstruction biliary strictures had a re-HJ. Twenty-three patients were managed with percutaneous transhepatic cholangiography and dilation. The overall success rate of re-establishing the biliodigestive flow approached 93%. No association was found between timing of repair, concomitant vascular injury, level of injury and stricture formation.CONCLUSION: In this national, unselected and consecutive cohort of patients with BDI repaired by early HJ we found a considerable risk of long-term complications (e.g. 30% stricture rate) and mortality in both the short- and the long-term perspective.

    U2 - 10.1111/hpb.12374

    DO - 10.1111/hpb.12374

    M3 - Journal article

    C2 - 25582034

    VL - 17

    SP - 394

    EP - 400

    JO - H P B

    JF - H P B

    SN - 1365-182X

    IS - 5

    ER -