Segmentary cholangitis after bile duct reconstruction for iatrogenic injury

Presenter: Alexandra Rueda De Leon MD | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Background: Dysfunction secondary to stenosis of the anastomosis and cholangitis are two parameters selected for evaluating outcomes bile duct repair. A number patients with normal levels bilirubin in serum no findings suggesting anastomotic dysfunction at image can be found have other clinical laboratory data cholangitis. These do not fulfill 3 criteria proposed by Tokyo Guidelines diagnosis cholangitis, but segmentary could diagnosed. Our objective was identify a group within our reconstruction database, so we an analysis etiology outcome this particular population. Methods: retrospective review identified all those who had least one visit emergency department center, then that fulfilled operational definition cholangitis: serum, fever and/or inflammatory response (elevated white blood count o elevated PCR levels), exclusion sources infection. Patients’ characteristics were reported calculating parametric or non-parametric descriptive statistics depending on population distribution. Chi-square test performed describe differences categorical variables. multivariate risk factors. Results: From 280 injury repairs, only 28 (10%) admitted their follow up ER. Of those, 11 (3.9%). When these evaluated ER 2 them received probable biliary repair disfunction, mild cholangitis; remain diagnosed as urinary tract infection, acute diarrhea, non-specifical abdominal pain. One intravenous antibiotics rest ambulatory treatment: three oral symptomatic treatment. We proceeded compare both populations, (n = 11) versus without 269). (Table). Then, including variables initially p <0.05, finding loss confluence (Strasberg lesions E4) history any kind complication following surgery statistically significant Outcomes compared between documented cases 34) eleven No signifiable liver functions during up, posterior interventions due disfunction repair, development cirrhosis, being enlisted transplant mortality. Conclusion: shows 3.9% reconstructed cases, develop. often misdiagnosed receive adequate treatment, even though long-term such cirrhosis different from presenting episodes Acknowledgement condition might necessary improving outcomes.