Long-term outcomes of choledochoduodenostomy for choledocholithiasis : increased incidence of postoperative cholangitis after total or distal gastrectomy
© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd..
PURPOSE: Choledochoduodenostomy (CDD) is performed to treat choledocholithiasis (CDL) cases where endoscopic stone removal is difficult. Recognizing CDD characteristics is important for CDL treatment planning.
METHODS: A total of 116 patients, including 33 patients ≥ 80 years old (29 with previous total gastrectomy, 19 with previous distal gastrectomy, 20 with built-up stones, 19 with periampullary diverticulum, 10 with confluence stones, 8 with repetitive recurrent stones, 4 with hard stones, 3 with endoscopic retrograde cholangiography [ERC] not available due to lack of cooperation, 2 with a history of pancreatitis post-ERC, and 2 in whom ERC could not be performed due to a disturbed anatomy) underwent CDD for CDL. Postoperative complications and long-term outcomes were evaluated.
RESULTS: The in-hospital mortality rate was 0%. The morbidity (grade ≥ IIIA according to the Clavien-Dindo classification) rates in the elderly (≥ 80 years old) and non-elderly (51-79 years old) patients were 3.0% (1/33) and 2.4% (2/83), respectively (p = 0.85). Long-term complications included cholangitis in eight (7%) patients, of which three cases were repetitive and seven had an operative history of total or distal gastrectomy. The incidence of postoperative cholangitis after total or distal gastrectomy was 15% (7/48), which was significantly higher than that involving other causes (1.5%, 1/68; p < 0.01). Two patients with cholangitis after total gastrectomy experienced early recurrence of lithiasis at 2 and 9 months after surgery.
CONCLUSIONS: CDD is safe, even in elderly patients. However, a history of total gastrectomy or distal gastrectomy may increase the incidence of postoperative cholangitis.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
|---|---|
| Enthalten in: |
Surgery today - 54(2024), 4 vom: 29. März, Seite 331-339 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Futagawa, Yasuro [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cholangitis |
|---|
| Anmerkungen: |
Date Completed 22.03.2024 Date Revised 22.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00595-023-02740-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36140719X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36140719X | ||
| 003 | DE-627 | ||
| 005 | 20240323000128.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00595-023-02740-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1341.xml |
| 035 | |a (DE-627)NLM36140719X | ||
| 035 | |a (NLM)37642741 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Futagawa, Yasuro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term outcomes of choledochoduodenostomy for choledocholithiasis |b increased incidence of postoperative cholangitis after total or distal gastrectomy |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.03.2024 | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. | ||
| 520 | |a PURPOSE: Choledochoduodenostomy (CDD) is performed to treat choledocholithiasis (CDL) cases where endoscopic stone removal is difficult. Recognizing CDD characteristics is important for CDL treatment planning | ||
| 520 | |a METHODS: A total of 116 patients, including 33 patients ≥ 80 years old (29 with previous total gastrectomy, 19 with previous distal gastrectomy, 20 with built-up stones, 19 with periampullary diverticulum, 10 with confluence stones, 8 with repetitive recurrent stones, 4 with hard stones, 3 with endoscopic retrograde cholangiography [ERC] not available due to lack of cooperation, 2 with a history of pancreatitis post-ERC, and 2 in whom ERC could not be performed due to a disturbed anatomy) underwent CDD for CDL. Postoperative complications and long-term outcomes were evaluated | ||
| 520 | |a RESULTS: The in-hospital mortality rate was 0%. The morbidity (grade ≥ IIIA according to the Clavien-Dindo classification) rates in the elderly (≥ 80 years old) and non-elderly (51-79 years old) patients were 3.0% (1/33) and 2.4% (2/83), respectively (p = 0.85). Long-term complications included cholangitis in eight (7%) patients, of which three cases were repetitive and seven had an operative history of total or distal gastrectomy. The incidence of postoperative cholangitis after total or distal gastrectomy was 15% (7/48), which was significantly higher than that involving other causes (1.5%, 1/68; p < 0.01). Two patients with cholangitis after total gastrectomy experienced early recurrence of lithiasis at 2 and 9 months after surgery | ||
| 520 | |a CONCLUSIONS: CDD is safe, even in elderly patients. However, a history of total gastrectomy or distal gastrectomy may increase the incidence of postoperative cholangitis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cholangitis | |
| 650 | 4 | |a Choledochoduodenostomy | |
| 650 | 4 | |a Choledocholithiasis | |
| 650 | 4 | |a Gastrectomy | |
| 650 | 4 | |a Long-term outcomes | |
| 700 | 1 | |a Yasuda, Jungo |e verfasserin |4 aut | |
| 700 | 1 | |a Shiozaki, Hironori |e verfasserin |4 aut | |
| 700 | 1 | |a Ikeda, Keiichi |e verfasserin |4 aut | |
| 700 | 1 | |a Onda, Shinji |e verfasserin |4 aut | |
| 700 | 1 | |a Okamoto, Tomoyoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ikegami, Toru |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Surgery today |d 1997 |g 54(2024), 4 vom: 29. März, Seite 331-339 |w (DE-627)NLM012623938 |x 1436-2813 |7 nnns |
| 773 | 1 | 8 | |g volume:54 |g year:2024 |g number:4 |g day:29 |g month:03 |g pages:331-339 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00595-023-02740-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 54 |j 2024 |e 4 |b 29 |c 03 |h 331-339 | ||