Acute Pancreatitis After Laparoscopic Transcystic Common Bile Duct Exploration: An Analysis of Predisposing Factors in 447 Patients.

Authors:
Matias E Czerwonko
Matias E Czerwonko
Children's Hospital of Philadelphia
Philadelphia | United States
Juan Pekolj
Juan Pekolj
Hospital Italiano de Buenos Aires
Italy
Pedro Uad
Pedro Uad
Instituto Universitario del Hospital Italiano de Buenos Aires
Argentina
Oscar Mazza
Oscar Mazza
Hospital Italiano de Buenos Aires
Italy
Guillermo Arbues
Guillermo Arbues
Hospital Italiano de Buenos Aires
Buenos Aires | Argentina

World J Surg 2018 10;42(10):3134-3142

Department of General Surgery, Division of HPB Surgery, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH, Buenos Aires, Argentina.

Introduction: In laparoscopic transcystic common bile duct exploration (LTCBDE), the risk of acute pancreatitis (AP) is well recognized. The present study assesses the incidence, risk factors, and clinical impact of AP in patients with choledocholithiasis treated with LTCBDE.

Methods: A retrospective database was completed including patients who underwent LTCBDE between 2007 and 2017. Univariate and multivariate analyses were performed by logistic regression.

Results: After exclusion criteria, 447 patients were identified. There were 70 patients (15.7%) who showed post-procedure hyperamylasemia, including 20 patients (4.5%) who developed post-LTCBDE AP. Of these, 19 were edematous and one was a necrotizing pancreatitis. Patients with post-LTCBDE AP were statistically more likely to have leukocytosis (p < 0.004) and jaundice (p = 0.019) before surgery and longer operative times (OT, p < 0.001); they were less likely to have incidental intraoperative diagnosis (p = 0.031) or to have biliary colic as the reason for surgery (p = 0.031). In the final multivariate model, leukocytosis (p = 0.013) and OT (p < 0.001) remained significant predictors for AP. Mean postoperative hospital stay (HS) was significantly longer in AP group (p < 0.001).

Conclusion: The risk of AP is moderate and should be considered in patients with preoperative leukocytosis and jaundice and exposed to longer OT. AP has a strong impact on postoperative HS.

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http://dx.doi.org/10.1007/s00268-018-4611-0DOI Listing
October 2018
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References

(Supplied by CrossRef)
Article in Surg Endosc
Y Aawsaj et al.
Surg Endosc 2016
Article in Surg Endosc
Y Cai et al.
Surg Endosc 2014
Article in Surg Endosc
YS Khaled et al.
Surg Endosc 2013
Article in Clin Res Hepatol Gastroenterol
H-Y Zhu et al.
Clin Res Hepatol Gastroenterol 2015
Article in Int J Surg
R Kenny et al.
Int J Surg 2014
Article in Am J Surg
DM Lauter et al.
Am J Surg 2000
Article in Gut
PA Banks et al.
Gut 2013
Article in Ann Surg
D Dindo et al.
Ann Surg 2004
Article in J Am Coll Surg
J Pekolj et al.
J Am Coll Surg 2013
Article in Br J Surg
ESJ Clayton et al.
Br J Surg 2006

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