Risk factors for early postoperative complications after hepaticojejunostomy for iatrogenic bile duct injury
10.3760/cma.j.cn113855-20191220-00759
- VernacularTitle:医源性胆管损伤行胆肠吻合术后近期并发症的危险因素分析
- Author:
Xiyang YAN
1
;
Hong XUE
;
Jiangming CHEN
;
Shengxue XIE
;
Fubao LIU
;
Qiang HUANG
;
Xiaoping GENG
Author Information
1. 安徽医科大学第二附属医院肝胆外科，合肥 230601
- From:
Chinese Journal of General Surgery
2020;35(8):628-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and related risk factors related to early postoperative complications after hepaticojejunostomy surgery for iatrogenic bile duct injury.Methods:A retrospective analysis was made on the data of 110 cases undergoing a hepaticojejunostomy at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital from January 2001 to December 2018. The univariate and multivariate analyses were performed to explore the impact risk factors on the short-term complications.Results:Patients′ median age was 44 years old. The short-term postoperative complication rate was 35.5% and the serious complication rate was 17.3%. Univariate analysis showed that male, a failed repair was attempted before referral, intraoperative bleeding>400 ml, and duration of surgery were significantly related to the occurrence of early postoperative complications (all P<0.05). Multivariate analysis showed that male, pre-referral failed surgical repair, preoperative bile leakage, initially combined with hepatectomy, and intraoperative bleeding>400 ml were independent risk factors for postoperative short term complications (all P<0.05). Univariate and multivariate analysis of early postoperative severe complications(Clavien-Dindo≥Ⅲ) revealed that pre-referral surgical repair, combined liver resection, and intraoperative bleeding>400 ml can significantly affect the occurrence of early postoperative severe complications (all P<0.05) . There was no significant correlation between the timing of biliary repair and the occurrence of complications ( P>0.05). Conclusions:Upon the occurrence of iatrogenic bile duct injury, the surgeon is advised to refrain from doing a repair instead sending the patient to a referral hospital. If bile leakage persists before surgery, sufficient bile drainage should be given priority to control infection.
