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Risk factors and outcomes for cholangitis after hepatic resection.
Mangieri, Christopher W; Strode, Matthew A; Moaven, Omeed; Valenzuela, Cristian D; Erali, Richard A; Howerton, Russell; Shen, Perry; Clark, Clancy J.
Afiliação
  • Mangieri CW; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA. christopher.w.mangieri.mil@health.mil.
  • Strode MA; Department of General Surgery, Womack Army Medical Center, Fort Bragg, USA.
  • Moaven O; Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
  • Valenzuela CD; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA.
  • Erali RA; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA.
  • Howerton R; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA.
  • Shen P; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA.
  • Clark CJ; Department of Surgery, Division of Surgical Oncology, Wake Forest University Baptist Health Medical Center, Winston-Salem, USA.
Langenbecks Arch Surg ; 408(1): 236, 2023 Jun 17.
Article em En | MEDLINE | ID: mdl-37329363
INTRODUCTION: There is a paucity in the literature in regard to the incidence, risk factors, and outcomes for post-operative cholangitis following hepatic resection. METHODS: Retrospective review of the ACS NSQIP main and targeted hepatectomy registries for 2012-2016. RESULTS: A total of 11,243 cases met the selection criteria. The incidence of post-operative cholangitis was 0.64% (151 cases). Multivariate analysis identified several risk factors associated with the development of post-operative cholangitis, stratified out by pre-operative and operative factors. The most significant risk factors were biliary anastomosis and pre-operative biliary stenting with odds ratios (OR) of 32.39 (95% CI 22.91-45.79, P value < 0.0001) and 18.32 (95% CI 10.51-31.94, P value < 0.0001) respectively. Cholangitis was significantly associated with post-operative bile leaks, liver failure, renal failure, organ space infections, sepsis/septic shock, need for reoperation, longer length of stay, increased readmission rates, and death. CONCLUSION: Largest analysis of post-operative cholangitis following hepatic resection. While a rare occurrence, it is associated with significantly increased risk for severe morbidity and mortality. The most significant risk factors were biliary anastomosis and stenting.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Biliares / Colangite Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Biliares / Colangite Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article