Background

Delayed biliary strictures (DBS) after cholecystectomy are uncommon and little is known of their aetiology or long-term consequences. The aims of this study were to investigate the clinical and economic impact of DBS after cholecystectomy.

Methods

Patients who developed DBS after cholecystectomy were identified from a prospectively collected and maintained database. Risk factors for stricture development, quality of life (QoL) and long-term biliary complication rates were explored. Costs of treatment and follow up were determined. The same outcomes among patients with minor or major bile duct injury (BDI) were used as a comparison.

Results

Among 44 patients, a laparoscopic converted to open procedure or post cholecystectomy bile leak affected some 18 and 12 patients respectively. Most DBS required surgical treatment (40). Over a median follow-up of 8.9 years after DBS treatment, 16 (36%) patients developed biliary complications (similar to minor, 26%, and major BDI, 40%) and 1 patient died of causes related to the biliary stricture. Costs of treating DBS and its follow up (£14,309.26 per patient), were similar to previously reported costs for major BDI (£15,784).

Discussion

DBS typically occur after a technically and/or complicated cholecystectomy. Clinical, economic and QoL outcomes are similar to patients with major BDI.

中文翻译：

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胆囊切除术后延迟性胆道狭窄的长期结果

背景

胆囊切除术后迟发性胆道狭窄 (DBS) 并不常见，对其病因或长期后果知之甚少。本研究的目的是调查胆囊切除术后 DBS 的临床和经济影响。

方法

从前瞻性收集和维护的数据库中识别出胆囊切除术后发生 DBS 的患者。探讨了狭窄发展、生活质量 (QoL) 和长期胆道并发症发生率的危险因素。确定治疗和随访费用。轻微或严重胆管损伤（BDI）患者的相同结果被用作比较。

结果

在 44 名患者中，腹腔镜转开放手术或胆囊切除术后胆漏分别影响了约 18 名和 12 名患者。大多数 DBS​​ 需要手术治疗 (40)。在 DBS 治疗后 8.9 年的中位随访中，16 名 (36%) 患者出现胆道并发症（类似于轻微的 BDI，26% 和严重的 BDI，40%），1 名患者死于与胆道狭窄相关的原因。治疗 DBS 及其随访的费用（每位患者 14,309.26 英镑）与之前报道的主要 BDI 费用（15,784 英镑）相似。

讨论

DBS 通常发生在技术性和/或复杂的胆囊切除术后。临床、经济和生活质量结果与主要 BDI 患者相似。