Complications of biliary-enteric anastomoses
R S Kadaba1,2, K A Bowers1, S Khorsandi1
1The Royal London Hospital, Barts Health NHS Trust , London , UK.
Annals of the Royal College of Surgeons of England
|September 24, 2016
Summary
Biliary-enteric anastomoses have low complication rates. Biliary reconstruction after injury and high anastomoses increase leak risk, while younger patients face higher stricture risk.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Biliary-enteric anastomoses are crucial surgical procedures with potential for early and late complications.
- Anastomotic leaks and strictures are significant concerns following these reconstructions.
Purpose of the Study:
- To identify risk factors for anastomotic leak and stricture after biliary-enteric anastomosis.
- To evaluate the management strategies for these complications.
Main Methods:
- Retrospective analysis of 10 years of patient data (2000-2010) from a tertiary referral center.
- Inclusion of 462 patients who underwent biliary-enteric anastomoses, primarily Roux-en-Y hepaticojejunostomy or choledocho-jejunostomy.
Main Results:
- Overall incidence of early bile leaks was 3.7% and late strictures was 3.7%.
- Multivariable analysis identified biliary reconstruction after injury (OR=6.84) and high anastomosis (OR=4.62) as significant risk factors for anastomotic leak.
- Younger age was a significant risk factor for anastomotic strictures.
Conclusions:
- Biliary-enteric anastomoses demonstrate a low incidence of complications.
- Specific surgical factors (reconstruction post-injury, high anastomosis) and patient demographics (younger age) are linked to increased risks of leak and stricture.
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