Quality-of-life after bile duct injury repaired by hepaticojejunostomy: a national cohort study

Scand J Gastroenterol. 2020 Sep;55(9):1087-1092. doi: 10.1080/00365521.2020.1800076. Epub 2020 Jul 31.

Abstract

Objectives: Reports on quality-of-life (QoL) after bile duct injury (BDI) show conflicting results. The aim of this cohort study was to evaluate QoL stratified according to type of treatment.

Methods: QoL assessment using the SF-36 (36-item short form health survey) questionnaire. Patients with post-cholecystectomy BDI needing hepaticojejunostomy (HJ) were compared to all other treatments (BDI repair) and to patients without BDI at cholecystectomy (controls).

Results: Patients needing a HJ after BDI reported reduced long-term QoL irrespective of time for diagnosis and repair in both the physical (PCS; p < .001) and mental (MCS; p < .001) domain compared to both controls and patients with less severe BDI. QoL was comparable for BDI repair (n = 86) and controls (n = 192) in both PCS (p = .171) and MCS (p = .654). As a group, patients with BDI (n = 155) reported worse QoL than controls, in both the PCS (p < .001) and MCS (p = .012). Patients with a BDI detected intraoperatively (n = 124) reported better QoL than patients with a postoperative diagnosis. Patients with an immediate intraoperative repair (n = 99), including HJ, reported a better long-term QoL compared to patients subjected to a later procedure (n = 54).

Conclusions: Patients with postoperative diagnosis and patients with BDIs needing biliary reconstruction with HJ both reported reduced long-term QoL.

Keywords: BDI; Quality-of-life; SF-36; bile duct injury; cholecystectomy; hepaticojejunostomy.

MeSH terms

  • Bile Duct Diseases*
  • Bile Ducts / surgery
  • Cholecystectomy
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Cohort Studies
  • Humans
  • Quality of Life