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Recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy: incidence and risk factors

Anouk G Overdevest1, Jeska A Fritzsche1, Mark A D Smit2

  • 1Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
|January 20, 2024
PubMed

Insights

Recurrent cholangitis can occur even in patients with a patent hepaticojejunostomy (HJ) anastomosis. This study found that 4.4% of patients experienced recurrent cholangitis without HJ stenosis, with male sex and benign disease as risk factors.

Area of Science:

  • Hepatobiliary and pancreatic surgery
  • Surgical complications
  • Gastroenterology

Background:

  • Cholangitis is a known complication following hepaticojejunostomy (HJ), often linked to anastomotic stenosis.
  • The incidence of cholangitis in patients with a patent (non-stenotic) HJ remains largely unknown.
  • Understanding cholangitis in non-stenotic HJ is crucial for improving patient outcomes post-surgery.

Purpose of the Study:

  • To determine the incidence of recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy (HJ).
  • To identify risk factors associated with recurrent cholangitis in the absence of HJ stenosis.

Main Methods:

  • A single-center retrospective cohort study included patients undergoing HJ surgery between 2015 and 2022.
  • The primary outcome was recurrent non-stenotic cholangitis.
  • Logistic regression analysis was used to identify risk factors for recurrent non-stenotic cholangitis.

Main Results:

  • Out of 835 patients with HJ, 4.4% (31/698) developed recurrent cholangitis with a non-stenotic anastomosis.
  • These patients experienced a median of 7.0 cholangitis episodes, with 34.6% requiring hospitalization.
  • Male sex (aOR 3.17) and benign disease (aOR 2.97) were significant risk factors for recurrent cholangitis in non-stenotic HJ.

Conclusions:

  • Approximately 4% of patients develop recurrent cholangitis despite having a patent hepaticojejunostomy (HJ).
  • Male sex and underlying benign disease are identified as key risk factors.
  • These findings highlight the need for vigilance and potential targeted management strategies for cholangitis in non-stenotic HJ.
Abstract

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