Publication:
Surgical reconstruction of major bile duct injuries: long-term results and risk factors for restenosis

dc.contributor.coauthorTekant, Yaman
dc.contributor.coauthorSerin, Kursat Rahmi
dc.contributor.coauthorIbis, Abdil Cem
dc.contributor.coauthorEkiz, Feza
dc.contributor.coauthorOzden, Ilgin
dc.contributor.departmentKUTTAM (Koç University Research Center for Translational Medicine)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorBaygül, Arzu Eden
dc.contributor.schoolcollegeinstituteResearch Center
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-01-19T10:29:08Z
dc.date.issued2023
dc.description.abstractBackground: A single-institution retrospective analysis was undertaken to assess long-term results of definitive surgical reconstruction for major bile duct injuries and risk factors for restenosis. Methods: Patients treated between January 1995 and October 2020 were reviewed retrospectively. The primary outcome measure was patency. Results: Of 417 patients referred to a tertiary center, 290 (69.5%) underwent surgical reconstruction; mostly in the form of a hepaticojejunostomy (n = 281, 96.8%). Major liver resection was undertaken in 18 patients (6.2%). There were 7 postoperative deaths (2.4%). Patency was achieved in 97.4% of primary repairs and 88.8% of re-repairs. Primary patency at three months (including postoperative deaths and stents removed afterwards) in primary repairs was significantly higher than secondary patency attained during the same period in re-repairs (89.3% vs 76.5%, p < 0.01). The actuarial primary patency was also significantly higher compared to the actuarial secondary patency 10 years after reconstruction (86.7% vs 70.4%, p = 0.001). Vascular disruption was the only independent predictor of loss of patency after reconstruction (OR 7.09, 95% CI 3.45-14.49, p < 0.001), showing interaction with injuries at or above the biliary bifurcation (OR 9.52, 95% CI 2.56-33.33, p < 0.001). Conclusions: Long-term outcome of surgical reconstruction for major bile duct injuries was superior in primary repairs compared to re-repairs. Concomitant vascular injury was independently associated with loss of patency requiring revision.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue1
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume21
dc.identifier.doi10.1016/j.surge.2022.03.003
dc.identifier.eissn2405-5840
dc.identifier.issn1479-666X
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85126888091
dc.identifier.urihttps://doi.org/10.1016/j.surge.2022.03.003
dc.identifier.urihttps://hdl.handle.net/20.500.14288/25838
dc.identifier.wos1062067600001
dc.keywordsCholecystectomy
dc.keywordsHepaticojejunostomy
dc.keywordsCholangitis
dc.keywordsRepair
dc.keywordsFistula
dc.language.isoeng
dc.publisherRoyal College Surgeons Edinburgh
dc.relation.ispartofSurgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
dc.subjectSurgery
dc.titleSurgical reconstruction of major bile duct injuries: long-term results and risk factors for restenosis
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorBaygül, Arzu Eden
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1Research Center
local.publication.orgunit2KUTTAM (Koç University Research Center for Translational Medicine)
local.publication.orgunit2School of Medicine
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