Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma
This study aims to provide a deep insight into the incidence and clinical significance of postoperative anastomotic leakage (AL) and anastomotic stenosis (AS) of the hepaticojejunostomy (HJ) after curative-intent liver resection for perihilar cholangiocarcinoma (pCCA). Between 2011 and mid-2019, 114...
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1392 |
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| author | Jan Bednarsch Zoltan Czigany Daniel Heise Sven Arke Lang Steven W. M. Olde Damink Tom Luedde Philipp Bruners Tom Florian Ulmer Ulf Peter Neumann |
| author_facet | Jan Bednarsch Zoltan Czigany Daniel Heise Sven Arke Lang Steven W. M. Olde Damink Tom Luedde Philipp Bruners Tom Florian Ulmer Ulf Peter Neumann |
| author_sort | Jan Bednarsch |
| collection | DOAJ |
| description | This study aims to provide a deep insight into the incidence and clinical significance of postoperative anastomotic leakage (AL) and anastomotic stenosis (AS) of the hepaticojejunostomy (HJ) after curative-intent liver resection for perihilar cholangiocarcinoma (pCCA). Between 2011 and mid-2019, 114 patients with pCCA underwent surgery in curative intent at our institution and were analyzed regarding the postoperative incidence of AL and AS. Further, associations between AL and AS and clinical characteristics were assessed using multiple univariate logistic regression analyses. AL was diagnosed in 11.4% (13/114) of the patients resulting in postoperative mortality in the minority of patients (23.0%, 3/13). AS occurred in 11.0% (11/100) of the individuals eligible for follow-up with local tumor recurrence being the underlying pathology in 72.7% (8/11) of the cases. None of the investigated clinical factors including surgical difficulty of the HJ showed a meaningful association with AL or AS. AL and AS are frequent complications and can be treated by conservative, interventional or surgical therapy with a high success rate. Also, technical difficulty of the HJ appears not to be not associated with the occurrence of AL or AS. Moreover, AS is associated with tumor recurrence in the majority of cases. |
| first_indexed | 2024-03-10T19:57:30Z |
| format | Article |
| id | doaj.art-74160de1cd6442898ec0805634c87516 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:57:30Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-74160de1cd6442898ec0805634c875162023-11-19T23:50:54ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195139210.3390/jcm9051392Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar CholangiocarcinomaJan Bednarsch0Zoltan Czigany1Daniel Heise2Sven Arke Lang3Steven W. M. Olde Damink4Tom Luedde5Philipp Bruners6Tom Florian Ulmer7Ulf Peter Neumann8Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Medicine III, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Radiology, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, GermanyThis study aims to provide a deep insight into the incidence and clinical significance of postoperative anastomotic leakage (AL) and anastomotic stenosis (AS) of the hepaticojejunostomy (HJ) after curative-intent liver resection for perihilar cholangiocarcinoma (pCCA). Between 2011 and mid-2019, 114 patients with pCCA underwent surgery in curative intent at our institution and were analyzed regarding the postoperative incidence of AL and AS. Further, associations between AL and AS and clinical characteristics were assessed using multiple univariate logistic regression analyses. AL was diagnosed in 11.4% (13/114) of the patients resulting in postoperative mortality in the minority of patients (23.0%, 3/13). AS occurred in 11.0% (11/100) of the individuals eligible for follow-up with local tumor recurrence being the underlying pathology in 72.7% (8/11) of the cases. None of the investigated clinical factors including surgical difficulty of the HJ showed a meaningful association with AL or AS. AL and AS are frequent complications and can be treated by conservative, interventional or surgical therapy with a high success rate. Also, technical difficulty of the HJ appears not to be not associated with the occurrence of AL or AS. Moreover, AS is associated with tumor recurrence in the majority of cases.https://www.mdpi.com/2077-0383/9/5/1392hepaticojejunostomyanastomotic leakageanastomotic stenosisperihilar cholangiocarcinoma (pCCA) |
| spellingShingle | Jan Bednarsch Zoltan Czigany Daniel Heise Sven Arke Lang Steven W. M. Olde Damink Tom Luedde Philipp Bruners Tom Florian Ulmer Ulf Peter Neumann Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma Journal of Clinical Medicine hepaticojejunostomy anastomotic leakage anastomotic stenosis perihilar cholangiocarcinoma (pCCA) |
| title | Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma |
| title_full | Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma |
| title_fullStr | Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma |
| title_full_unstemmed | Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma |
| title_short | Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma |
| title_sort | leakage and stenosis of the hepaticojejunostomy following surgery for perihilar cholangiocarcinoma |
| topic | hepaticojejunostomy anastomotic leakage anastomotic stenosis perihilar cholangiocarcinoma (pCCA) |
| url | https://www.mdpi.com/2077-0383/9/5/1392 |
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