The Clinical Features of Late Postoperative Cholangitis After Hepaticojejunostomy Brought on by Conditions other than Cancer Recurrence

Am Surg. 2024 Apr;90(4):800-809. doi: 10.1177/00031348231212585. Epub 2023 Nov 2.

Abstract

Purpose: Postoperative cholangitis and anastomotic strictures (AS) are long-term complications of biliary-enteric anastomosis (BEA).

Methods: We retrospectively reviewed data of patients who underwent bile duct resection with or without hepatectomy and investigated the risk factors for postoperative cholangitis, benign AS, and incidence of Clavien-Dindo (C-D) >Grade III complications.

Results: Overall, data of 189 patients (115 men and 74 women) were retrospectively analyzed. The median patient age was 73 years. Thirty-five patients (18.5%) developed postoperative cholangitis, and 16 (8.4%) developed postoperative AS. Male sex and serious postoperative complications (C-D ≥ Grade III) were independent risk factors for cholangitis. The incidence of serious postoperative complications was 32.3%. Hypertension, preoperative biliary drainage, C-reactive protein-albumin ratio ≥.22, and bile duct resection with hepatectomy were potential risk factors for serious postoperative complications.

Conclusions: The incidence rates of postoperative cholangitis and AS after BEA were 18.5% and 8.4%, respectively. Male sex and serious postoperative complications (C-D ≥ Grade III) were independent risk factors for postoperative cholangitis.

Keywords: biliary stenosis; complication; hepaticojejunostomy.

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Cholangitis* / epidemiology
  • Cholangitis* / etiology
  • Female
  • Humans
  • Male
  • Neoplasms*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies