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Hepaticojejunostomy—Analysis of Risk Factors for Postoperative Bile Leaks and Surgical Complications

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Anastomoses between the jejunum and the bile duct are an important component of many surgical procedures; however, risk factors for clinically relevant bile leaks have not yet been adequately defined. The objective of this study was to describe the incidence of bile leaks after hepaticojejunostomy and to define predictive factors associated with this risk and with surgical morbidity. Between October 2001 and April 2004, hepaticojejunostomies were performed in 519 patients in a standardized way. Patient- and treatment-related data were documented prospectively. A bile leak was defined as bilirubin concentration in the drains exceeding serum bilirubin with a consecutive change of clinical management or occurrence of a bilioma necessitating drainage. Surgical morbidity occurred in 15% of patients, the incidence of a bile leak was 5.6%. Multivariate analysis confirmed preoperative radiochemotherapy, preoperative low cholinesterase levels, biliary complications after liver transplantation necessitating a hepaticojejunostomy, and simultaneous liver resection as risk factors for bile leakages, whereas biliary complications after liver transplantation necessitating hepaticojejunostomy, simultaneous liver resection, and diabetes mellitus were significantly associated with postoperative surgical morbidity. Our results demonstrate that hepaticojejunostomy is a safe procedure if performed in a standardized fashion. The above found factors may help to better predict the risk for complications after hepaticojejunostomy.

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Authors and Affiliations

  1. Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Dalibor Antolovic, Moritz Koch, Luis Galindo, Sandra Wolff, Emira Music, Peter Kienle, Peter Schemmer, Helmut Friess, Jan Schmidt, Markus W. Büchler & Jürgen Weitz

Authors
  1. Dalibor Antolovic
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  2. Moritz Koch
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  3. Luis Galindo
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  4. Sandra Wolff
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  5. Emira Music
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  6. Peter Kienle
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  7. Peter Schemmer
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  8. Helmut Friess
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  9. Jan Schmidt
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  10. Markus W. Büchler
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  11. Jürgen Weitz
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Corresponding author

Correspondence to Jürgen Weitz.

Additional information

Dalibor Antolovic and Moritz Koch contributed equally to this study.

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Antolovic, D., Koch, M., Galindo, L. et al. Hepaticojejunostomy—Analysis of Risk Factors for Postoperative Bile Leaks and Surgical Complications. J Gastrointest Surg 11, 555–561 (2007). https://doi.org/10.1007/s11605-007-0166-3

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  • DOI: https://doi.org/10.1007/s11605-007-0166-3

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