TY - JOUR
T1 - Recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy
T2 - incidence and risk factors
AU - Overdevest, Anouk G.
AU - Fritzsche, Jeska A.
AU - Smit, Mark A. D.
AU - Besselink, Marc G.
AU - Bonomi, Alessandro M.
AU - Busch, Olivier R.
AU - Daams, Freek
AU - van Delden, Otto M.
AU - Kazemier, Geert
AU - Langver, Jesse
AU - Ponsioen, Cyriel Y.
AU - Swijnenburg, Rutger-Jan
AU - van Wanrooij, Roy L. J.
AU - Wielenga, Mattheus C. B.
AU - Zonderhuis, Babs M.
AU - Zijlstra, I. Jsbrand A. J.
AU - Erdmann, Joris I.
AU - Voermans, Rogier P.
N1 - Publisher Copyright: © 2024 The Authors
PY - 2024/4
Y1 - 2024/4
N2 - Background: Cholangitis is a well-known complication after hepaticojejunostomy (HJ), which is mainly caused by a stenotic anastomosis. However, the rate of cholangitis in patients with a non-stenotic (i.e. patent) HJ is unknown. We aimed to evaluate the incidence and risk factors of recurrent cholangitis in patients with a non-stenotic HJ. Methods: This single-center retrospective cohort study included all consecutive patients who had undergone hepatobiliary or pancreatic (HPB) surgery requiring HJ (2015–2022). Primary outcome was recurrent non-stenotic cholangitis, risk factors for recurrent non-stenotic cholangitis were identified using logistic regression. Results: Overall, 835 patients with a HJ were included of whom 31/698 (4.4%) patients developed recurrent cholangitis with a non-stenotic HJ during a median follow-up of 34 months (IQR 22–50) and 98/796 (12.3%) patients developed a symptomatic HJ stenosis. These 31 patients experienced 205 cholangitis episodes, median 7.0 (IQR 3.8–8.8) per patient, and 71/205 (34.6%) cholangitis episodes required hospitalization. Male sex (aOR 3.17 (95% CI: 1.34–7.49)) and benign disease (aOR 2.97, 95% CI 1.40–6.33) were identified as risk factors for recurrent cholangitis in non-stenotic HJ in both univariate and multivariable analysis. Conclusion: This study shows that 4% of patients developed recurrent cholangitis without an underlying HJ stenosis.
AB - Background: Cholangitis is a well-known complication after hepaticojejunostomy (HJ), which is mainly caused by a stenotic anastomosis. However, the rate of cholangitis in patients with a non-stenotic (i.e. patent) HJ is unknown. We aimed to evaluate the incidence and risk factors of recurrent cholangitis in patients with a non-stenotic HJ. Methods: This single-center retrospective cohort study included all consecutive patients who had undergone hepatobiliary or pancreatic (HPB) surgery requiring HJ (2015–2022). Primary outcome was recurrent non-stenotic cholangitis, risk factors for recurrent non-stenotic cholangitis were identified using logistic regression. Results: Overall, 835 patients with a HJ were included of whom 31/698 (4.4%) patients developed recurrent cholangitis with a non-stenotic HJ during a median follow-up of 34 months (IQR 22–50) and 98/796 (12.3%) patients developed a symptomatic HJ stenosis. These 31 patients experienced 205 cholangitis episodes, median 7.0 (IQR 3.8–8.8) per patient, and 71/205 (34.6%) cholangitis episodes required hospitalization. Male sex (aOR 3.17 (95% CI: 1.34–7.49)) and benign disease (aOR 2.97, 95% CI 1.40–6.33) were identified as risk factors for recurrent cholangitis in non-stenotic HJ in both univariate and multivariable analysis. Conclusion: This study shows that 4% of patients developed recurrent cholangitis without an underlying HJ stenosis.
UR - http://www.scopus.com/inward/record.url?scp=85182993929&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2024.01.003
DO - https://doi.org/10.1016/j.hpb.2024.01.003
M3 - Article
C2 - 38245491
SN - 1365-182X
VL - 26
SP - 558
EP - 564
JO - HPB
JF - HPB
IS - 4
ER -