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KMID : 1188320130070030352
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Gut and Liver
2013 Volume.7 No. 3 p.352 ~ p.356
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Risk Factors for Development of Biliary Stricture in Patients Presenting with Bile Leak after Cholecystectomy
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Hosur Mayanna Lokesh
Biju Pottakkat
Anand Prakash
Rajneesh Kumar Singh
Anu Behari
Ashok Kumar
Vinay Kumar Kapoor
Rajan Saxena
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Abstract
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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.
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KEYWORD
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Cholecystectomy, Bile ducts, Injuries
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