Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun;46(6):1465-1473.
doi: 10.1007/s00268-022-06511-2. Epub 2022 Mar 19.

Clinically Relevant Late-Onset Biliary Complications After Pancreatoduodenectomy

Minako Nagai  1 , Kenji Nakagawa  1 , Satoshi Nishiwada  1 , Taichi Terai  1 , Daisuke Hokuto  1 , Satoshi Yasuda  1 , Yasuko Matsuo  1 , Shunsuke Doi  1 , Takahiro Akahori  1 , Masayuki Sho  2
Affiliations

Clinically Relevant Late-Onset Biliary Complications After Pancreatoduodenectomy

Minako Nagai et al. World J Surg. 2022 Jun.

Abstract

Background: Late-onset biliary complications (LBC) after pancreatoduodenectomy (PD) can be serious. This study aimed to clarify the frequency and risk factors of severe LBC after PD.

Methods: We defined LBC as biliary complications occurring 3 months after PD and severe LBC as cases that required intensive care. A total of 318 patients who underwent PD between 2010 and 2018 with at least 1 year of postoperative follow-up were evaluated.

Results: Hospitalization for severe LBC was required in 59 patients (19%), of whom 20 had liver abscesses (6.3%); 18, acute cholangitis (5.7%); 12, biliary stones (3.8%); and 21, biliary strictures (6.6%). Interventional radiological or endoscopic treatment was required in 32 patients (10%), of whom 9 had a benign primary disease with biliary stones and/or strictures. Thirteen of the remaining 23 patients with a malignant primary disease had liver abscesses and cholangitis. Significant independent risk factors for severe LBC in patients with malignant primary disease were recurrence around the hepaticojejunostomy (odds ratio 6.5, P = 0.013) and chemotherapy (odds ratio 13.5, P < 0.001).

Conclusions: Severe LBC after PD may occur regardless of whether the primary disease is benign or malignant. The course of severe LBC differs according to the primary disease, and therefore, appropriate follow-up and optimal treatment should be recommended according to the condition of the patient and the disease state.

PubMed Disclaimer

References

    1. Smits FJ, van Santvoort HC, Besselink MG et al (2017) Management of severe pancreatic fistula after pancreatoduodenectomy. JAMA Surg 152(6):540–548. https://doi.org/10.1001/jamasurg.2016.5708 - DOI - PubMed - PMC
    1. Futagawa Y, Kanehira M, Furukawa K et al (2017) Impact of delayed gastric emptying after pancreaticoduodenectomy on survival. J Hepato Bil Pancreat Sci 24(8):466–474. https://doi.org/10.1002/jhbp.482 - DOI
    1. Nakamura K, Sho M, Satoi S et al (2020) Impact of antithrombotic agents on postpancreatectomy hemorrhage: results from a retrospective multicenter study. J Am Coll Surg 231(4):460–469. https://doi.org/10.1016/j.jamcollsurg.2020.06.017 - DOI - PubMed
    1. Prawdzik C, Belyaev O, Chromik AM et al (2015) Surgical revision of hepaticojejunostomy strictures after pancreatectomy. Langenbecks Arch Surg 400(1):67–75. https://doi.org/10.1007/s00423-014-1246-y - DOI - PubMed
    1. Nagai M, Sho M, Akahori T et al (2019) Risk factors for late-onset gastrointestinal hemorrhage after pancreatoduodenectomy for pancreatic cancer. World J Surg 43(2):626–633. https://doi.org/10.1007/s00268-018-4791-7 - DOI - PubMed

MeSH terms

LinkOut - more resources