Risk Factors for Development of Biliary Stricture in Patients Presenting with Bile Leak after Cholecystectomy.
- Author:
Hosur Mayanna LOKESH
1
;
Biju POTTAKKAT
;
Anand PRAKASH
;
Rajneesh Kumar SINGH
;
Anu BEHARI
;
Ashok KUMAR
;
Vinay Kumar KAPOOR
;
Rajan SAXENA
Author Information
- Publication Type:Original Article
- Keywords: Cholecystectomy; Bile ducts; Injuries
- MeSH: Alkaline Phosphatase; Bile; Bile Ducts; Biliary Fistula; Bilirubin; Cholecystectomy; Constriction, Pathologic; Female; Humans; Jaundice; Referral and Consultation; Retrospective Studies; Risk Factors
- From:Gut and Liver 2013;7(3):352-356
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: This study was aimed at determining the factors associated with the development of benign biliary stricture (BBS) in patients who had sustained a bile duct injury (BDI) at cholecystectomy and developed bile leaks. METHODS: A retrospective analysis of 214 patients with BDI who were referred to our center between January 1989 and December 2009 was done. RESULTS: One hundred fifty-three (71%) patients developed BBS (group I), and 61 (29%) were normal (group II). By univariate analysis, female gender (p=0.02), open cholecystectomy as the index operation (p=0.0001), delay in the referral from identification of injury (p=0.04), persistence of an external biliary fistula (EBF) beyond 4 weeks (p=0.0001), EBF output >400 mL (p=0.01), presence of jaundice (p=0.0001), raised serum total bilirubin level (p=0.0001), raised serum alkaline phosphatase level (p=0.0001), and complete BDI (p=0.0001) were associated with the development of BBS. Furthermore, open cholecystectomy as the index operation (p=0.04), delayed referral (p=0.02), persistent EBF (p=0.03), and complete BDI (p=0.001) were found to predict patient outcome in the multivariate analysis. CONCLUSIONS: For the majority of patients with BDI, the risk of developing BBS could have been predicted at the initial presentation.
