Textbook outcome in patients with biliary duct injury during cholecystectomy
Copyright © 2024. Published by Elsevier Inc..
BACKGROUND: Iatrogenic bile duct injury (BDI) during cholecystectomy is associated with a complex and heterogeneous management owing to the burden of morbidity until their definitive treatment. This study aimed to define the textbook outcomes (TOs) after BDI with the purpose to indicate the ideal treatment and to improve it management.
METHODS: We collected data from patients with an BDI between 1990 and 2022 from 27 hospitals. TO was defined as a successful conservative treatment of the iatrogenic BDI or only minor complications after BDI or patients in whom the first repair resolves the iatrogenic BDI without complications or with minor complications.
RESULTS: We included 808 patients and a total of 394 patients (46.9%) achieved TO. Overall complications in TO and non-TO groups were 11.9% and 86%, respectively (P < .001). Major complications and mortality in the non-TO group were 57.4% and 9.2%, respectively. The use of end-to-end bile duct anastomosis repair was higher in the non-TO group (23.1 vs 7.8, P < .001). Factors associated with achieving a TO were injury in a specialized center (adjusted odds ratio [aOR], 4.01; 95% CI, 2.68-5.99; P < .001), transfer for a first repair (aOR, 5.72; 95% CI, 3.51-9.34; P < .001), conservative management (aOR, 5.00; 95% CI, 1.63-15.36; P = .005), or surgical management (aOR, 2.45; 95% CI, 1.50-4.00; P < .001).
CONCLUSION: TO largely depends on where the BDI is managed and the type of injury. It allows hepatobiliary centers to identify domains of improvement of perioperative management of patients with BDI.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract - (2024) vom: 21. Feb. |
| Sprache: |
Englisch |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 13.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.gassur.2024.02.027 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369697456 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369697456 | ||
| 003 | DE-627 | ||
| 005 | 20240315000315.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240315s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.gassur.2024.02.027 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1329.xml |
| 035 | |a (DE-627)NLM369697456 | ||
| 035 | |a (NLM)38480039 | ||
| 035 | |a (PII)S1091-255X(24)00334-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lopez-Lopez, Victor |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Textbook outcome in patients with biliary duct injury during cholecystectomy |
| 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 Revised 13.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024. Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: Iatrogenic bile duct injury (BDI) during cholecystectomy is associated with a complex and heterogeneous management owing to the burden of morbidity until their definitive treatment. This study aimed to define the textbook outcomes (TOs) after BDI with the purpose to indicate the ideal treatment and to improve it management | ||
| 520 | |a METHODS: We collected data from patients with an BDI between 1990 and 2022 from 27 hospitals. TO was defined as a successful conservative treatment of the iatrogenic BDI or only minor complications after BDI or patients in whom the first repair resolves the iatrogenic BDI without complications or with minor complications | ||
| 520 | |a RESULTS: We included 808 patients and a total of 394 patients (46.9%) achieved TO. Overall complications in TO and non-TO groups were 11.9% and 86%, respectively (P < .001). Major complications and mortality in the non-TO group were 57.4% and 9.2%, respectively. The use of end-to-end bile duct anastomosis repair was higher in the non-TO group (23.1 vs 7.8, P < .001). Factors associated with achieving a TO were injury in a specialized center (adjusted odds ratio [aOR], 4.01; 95% CI, 2.68-5.99; P < .001), transfer for a first repair (aOR, 5.72; 95% CI, 3.51-9.34; P < .001), conservative management (aOR, 5.00; 95% CI, 1.63-15.36; P = .005), or surgical management (aOR, 2.45; 95% CI, 1.50-4.00; P < .001) | ||
| 520 | |a CONCLUSION: TO largely depends on where the BDI is managed and the type of injury. It allows hepatobiliary centers to identify domains of improvement of perioperative management of patients with BDI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bile duct injury | |
| 650 | 4 | |a Morbidity | |
| 650 | 4 | |a Outcomes | |
| 700 | 1 | |a Kuemmerli, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Maupoey, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a López-Andujar, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Lladó, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Mils, Kristel |e verfasserin |4 aut | |
| 700 | 1 | |a Müller, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Valdivieso, Andres |e verfasserin |4 aut | |
| 700 | 1 | |a Garcés-Albir, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Sabater, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Cacciaguerra, Andrea Benedetti |e verfasserin |4 aut | |
| 700 | 1 | |a Vivarelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Valladares, Luis Díez |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez, Sergio Annese |e verfasserin |4 aut | |
| 700 | 1 | |a Flores, Benito |e verfasserin |4 aut | |
| 700 | 1 | |a Brusadin, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Conesa, Asunción López |e verfasserin |4 aut | |
| 700 | 1 | |a Cortijo, Sagrario Martinez |e verfasserin |4 aut | |
| 700 | 1 | |a Paterna, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Serrablo, Alejando |e verfasserin |4 aut | |
| 700 | 1 | |a Toop, Ferdinand Heinz Walther |e verfasserin |4 aut | |
| 700 | 1 | |a Oldhafer, Karl |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Cabús, Santiago |e verfasserin |4 aut | |
| 700 | 1 | |a Gil, Antonio González |e verfasserin |4 aut | |
| 700 | 1 | |a Masía, Jose Antonio González |e verfasserin |4 aut | |
| 700 | 1 | |a Loinaz, Carmelo |e verfasserin |4 aut | |
| 700 | 1 | |a Lucena, Jose Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Pastor, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Zamora, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Calero, Alicia |e verfasserin |4 aut | |
| 700 | 1 | |a Valiente, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Minguillon, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Rotellar, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Alcazar, Cándido |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilo, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Cutillas, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Ruiperez-Valiente, Jose A |e verfasserin |4 aut | |
| 700 | 1 | |a Ramírez, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Petrowsky, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Ramia, Jose Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Robles-Campos, Ricardo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract |d 1997 |g (2024) vom: 21. Feb. |w (DE-627)NLM096454490 |x 1873-4626 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:21 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.gassur.2024.02.027 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 21 |c 02 | ||