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- W4313180523 abstract "Introduction: Biliary leakage after biliary reconstruction (BR) is a common complication.Bile duct resection with combined liver resection (LR) increases the risk of complications even further. Literature on surgical outcome for BR in combination with LR is sparse and clinical management challenging. We therefore aimed to determine the incidence and risk factors for complications after combined liver and bile duct resection with a focus on operative or endoscopic re-interventions. Method: Data from consecutive patients who underwent LR and BR between 2004 and 2018 in 11 academic institutions in Europe were collected from prospectively maintained databases. Results: Within a median follow-up of 34 months, 921 patients underwent LR with concomitant BR. Re-intervention (surgical or endoscopical) rate was 5.4%. Male sex (p=0.048), perineural infiltration (p<0.001), preoperative jaundice (p<0.001), use of preoperative biliary drainage (p<0.001), intraoperative biliary drainage (p=0.007), Pringle maneuver (p<0.001) and postoperative abdominal drainage (p<0.001) increased the risk of re-intervention after LR and BR. Moreover, overall morbidity other than related to BR was 84%. Re-intervention correlated with increased incidence of postoperative liver failure (p=0.036), bile leakage on cut surface, cholangitis, hemorrhage and sepsis (all p<0.001). Median overall survival was comparable for patients with and without need for re-intervention (36 vs. 32months). Conclusions: This multicenter data provides the largest series to date of LR with BR and could help in the management of these patients which are often challenging and hampering the patients` postoperative course negatively." @default.
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- W4313180523 date "2022-01-01" @default.
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- W4313180523 title "Incidence and Risk Factors for Re-interventions after Liver Resection and Bilioenteric Reconstruction: A International Multicenter Study" @default.
- W4313180523 doi "https://doi.org/10.1016/j.hpb.2022.05.295" @default.
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