Effect of liver steatosis in outcome after bile duct reconstruction for iatrogenic injury.
BACKGROUND
The estimated prevalence of nonalcoholic fatty liver disease (NAFLD) in the overall population is 30%. Bile duct injuries associated with cholecystectomy have a constant frequency and some patients with these types of injuries have concomitant hepatic stenosis (HS). It has not been determined if HS has a negative outcome on the results of surgical bile duct repair.


METHODS
Among a cohort of patients surgically repaired for bile duct injury, we selected those from whom a liver biopsy was obtained. Patients were divided into the following groups: group I--HS, group II--without HS. The groups were compared for long-term results of the reconstruction, postoperative complications, liver function test and need for reintervention.


RESULTS
From group I we obtained 18 patients and from group II 71 patients. In 11% of the HS group and in 10% of the non-HS group anastomosis dysfunction was observed. Three cases in group I (17%) and 11 patients in group II (15.5%) needed further surgical reintervention. Complete rehabilitation was obtained in 77% of the cases in group I and 66% of patients in group II. No statistical differences were found in any features between groups.


CONCLUSIONS
Patients with HS have a higher incidence of gallstone disease than the general population; hence, an increased probability of having a bile duct injury. The results of surgical reconstruction after these injuries are similar to those of patients without HS. Analyzed data showed no repercussion in outcome of patients with HS.
Mercado Díaz
Miguel Angel
MA
Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D F, Mexico. miguel.mercadod@quetzal.innsz.mx
Marcué
Miguel Urencio
MU
Ramírez Del Val
Fernando
F
Domínguez Rosado
Ismael
I
D000328:Adult; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome