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Quality-of-life after bile duct injury : intraoperative detection is crucial. A national case-control study

Rystedt, Jenny M L LU and Montgomery, Agneta K. LU (2016) In HPB 18(12). p.1010-1016
Abstract

Background Existing reports on quality-of-life (QoL) after bile duct injury (BDI) are conflicting. Methods Case-control study were QoL assessment was performed using SF-36 (36-item short Form health survey). Patients with BDI were compared to a matched control group (1:2) subject to cholecystectomy. Results In total 168 BDIs (0.3%) were eligible for participation and 64% returned SF-36. Median follow-up was 4.3 years. Intraoperative cholangiography was performed/attempted in 93% of BDI patients and 92% were diagnosed intraoperatively. Lesions <5 mm dominated (59%) and QoL was comparable for BDIs and controls (physical composite score PCS; p = 0.052 and mental composite score MCS; p = 0.478). Patients with an immediate intraoperative... (More)

Background Existing reports on quality-of-life (QoL) after bile duct injury (BDI) are conflicting. Methods Case-control study were QoL assessment was performed using SF-36 (36-item short Form health survey). Patients with BDI were compared to a matched control group (1:2) subject to cholecystectomy. Results In total 168 BDIs (0.3%) were eligible for participation and 64% returned SF-36. Median follow-up was 4.3 years. Intraoperative cholangiography was performed/attempted in 93% of BDI patients and 92% were diagnosed intraoperatively. Lesions <5 mm dominated (59%) and QoL was comparable for BDIs and controls (physical composite score PCS; p = 0.052 and mental composite score MCS; p = 0.478). Patients with an immediate intraoperative repair reported a better PCS than patients subjected to a later repair and/or referral (p = 0.002). No difference in SF-36 was detected when the BDI was repaired by the index compared to non-index surgeon (PCS p = 0.446, MCS p = 0.525). Conclusion QoL after bile duct injury is comparable to uneventful cholecystectomy, as long as the injury is diagnosed intraoperatively. Immediate repair, in this cohort of mainly minor injuries, also performed by the index surgeon, resulted in similar QoL as in the control group. We suggest liberal use of cholangiography for early detection of BDI, and intraoperative repair whenever possible.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
HPB
volume
18
issue
12
pages
7 pages
publisher
Informa Healthcare
external identifiers
  • scopus:84999635735
  • wos:000390044100006
ISSN
1365-182X
DOI
10.1016/j.hpb.2016.09.003
language
English
LU publication?
yes
id
d6f054aa-5cd1-40c4-8438-5064be5716c8
date added to LUP
2016-12-16 12:59:19
date last changed
2017-10-08 04:56:11
@article{d6f054aa-5cd1-40c4-8438-5064be5716c8,
  abstract     = {<p>Background Existing reports on quality-of-life (QoL) after bile duct injury (BDI) are conflicting. Methods Case-control study were QoL assessment was performed using SF-36 (36-item short Form health survey). Patients with BDI were compared to a matched control group (1:2) subject to cholecystectomy. Results In total 168 BDIs (0.3%) were eligible for participation and 64% returned SF-36. Median follow-up was 4.3 years. Intraoperative cholangiography was performed/attempted in 93% of BDI patients and 92% were diagnosed intraoperatively. Lesions &lt;5 mm dominated (59%) and QoL was comparable for BDIs and controls (physical composite score PCS; p = 0.052 and mental composite score MCS; p = 0.478). Patients with an immediate intraoperative repair reported a better PCS than patients subjected to a later repair and/or referral (p = 0.002). No difference in SF-36 was detected when the BDI was repaired by the index compared to non-index surgeon (PCS p = 0.446, MCS p = 0.525). Conclusion QoL after bile duct injury is comparable to uneventful cholecystectomy, as long as the injury is diagnosed intraoperatively. Immediate repair, in this cohort of mainly minor injuries, also performed by the index surgeon, resulted in similar QoL as in the control group. We suggest liberal use of cholangiography for early detection of BDI, and intraoperative repair whenever possible.</p>},
  author       = {Rystedt, Jenny M L and Montgomery, Agneta K.},
  issn         = {1365-182X},
  language     = {eng},
  month        = {12},
  number       = {12},
  pages        = {1010--1016},
  publisher    = {Informa Healthcare},
  series       = {HPB},
  title        = {Quality-of-life after bile duct injury : intraoperative detection is crucial. A national case-control study},
  url          = {http://dx.doi.org/10.1016/j.hpb.2016.09.003},
  volume       = {18},
  year         = {2016},
}