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. 2013 May;7(3):352-6.
doi: 10.5009/gnl.2013.7.3.352. Epub 2013 May 13.

Risk factors for development of biliary stricture in patients presenting with bile leak after cholecystectomy

Hosur Mayanna Lokesh  1 , Biju Pottakkat, Anand Prakash, Rajneesh Kumar Singh, Anu Behari, Ashok Kumar, Vinay Kumar Kapoor, Rajan Saxena
Affiliations

Risk factors for development of biliary stricture in patients presenting with bile leak after cholecystectomy

Hosur Mayanna Lokesh et al. Gut Liver. 2013 May.

Abstract

Background/aims: This study was aimed at determining the factors associated with the development of benign biliary stricture (BBS) in patients who had sustained a bile duct injury (BDI) at cholecystectomy and developed bile leaks.

Methods: A retrospective analysis of 214 patients with BDI who were referred to our center between January 1989 and December 2009 was done.

Results: One hundred fifty-three (71%) patients developed BBS (group I), and 61 (29%) were normal (group II). By univariate analysis, female gender (p=0.02), open cholecystectomy as the index operation (p=0.0001), delay in the referral from identification of injury (p=0.04), persistence of an external biliary fistula (EBF) beyond 4 weeks (p=0.0001), EBF output >400 mL (p=0.01), presence of jaundice (p=0.0001), raised serum total bilirubin level (p=0.0001), raised serum alkaline phosphatase level (p=0.0001), and complete BDI (p=0.0001) were associated with the development of BBS. Furthermore, open cholecystectomy as the index operation (p=0.04), delayed referral (p=0.02), persistent EBF (p=0.03), and complete BDI (p=0.001) were found to predict patient outcome in the multivariate analysis.

Conclusions: For the majority of patients with BDI, the risk of developing BBS could have been predicted at the initial presentation.

Keywords: Bile ducts; Cholecystectomy; Injuries.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Initial presentation of patients with bile duct injury.
Fig. 2
Fig. 2
Initial management and outcome of patients with acute bile duct injury.
Fig. 3
Fig. 3
Final outcome of patients with acute bile duct injury.
See this image and copyright information in PMC

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