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Impact of previous cyst-enterostomy on patients' outcome following resection of bile duct cysts

Abstract : AIM: To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts (BDC) resection. METHODS: A multicenter European retrospective study between 1974 and 2011 were conducted by the French Surgical Association. Only Todani subtypes I and IVb were included. Diagnostic imaging studies and operative and pathology reports underwent central revision. Patients with and without a previous history of cystenterostomy (CE) were compared. RESULTS: Among 243 patients with Todani types I and IVb BDC, 16 had undergone previous CE (6.5%). Patients with a prior history of CE experienced a greater incidence of preoperative cholangitis (75% vs 22.9%, P < 0.0001), had more complicated presentations (75% vs 40.5%, P = 0.007), and were more likely to have synchronous biliary cancer (31.3% vs 6.2%, P = 0.004) than patients without a prior CE. Overall morbidity (75% vs 33.5%; P < 0.0008), severe complications (43.8% vs 11.9%; P = 0.0026) and reoperation rates (37.5% vs 8.8%; P = 0.0032) were also significantly greater in patients with previous CE, and their Mayo Risk Score, during a median follow-up of 37.5 mo (range: 4-372 mo) indicated significantly more patients with fair and poor results (46.1% vs 15.6%; P = 0.0136). CONCLUSION: This is the large series to show that previous CE is associated with poorer short-and long-term results after Todani types I and IVb BDC resection.
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Submitted on : Friday, September 9, 2016 - 2:32:38 PM
Last modification on : Wednesday, September 16, 2020 - 5:49:17 PM

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Mehdi Ouaissi, Reza Kianmanesh, Emilia Ragot, Jacques Belghiti, Pietro Majno, et al.. Impact of previous cyst-enterostomy on patients' outcome following resection of bile duct cysts. World Journal of Gastrointestinal Surgery, Baishideng Publishing Group, 2016, 8 (6), pp.427--435. ⟨10.4240/wjgs.v8.i6.427⟩. ⟨hal-01363193⟩

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