Strict Surgical Repair for Bile Leakage Following the Roux-en-Y Hepaticojejunostomy

Frontiers in Surgery

Kai Gao²  Chunbao Guo²  Linfeng Wu⁴  Keying Zhang⁴  Chengwei Yan⁶  Chao Zheng⁸ 

[1] China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China;Chongqing Engineering Research Center of Stem Cell Therapy, Children’s Hospital of Chongqing Medical University, Chongqing, China;Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China;College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China;Department of Orthopaedics, Children’s Hospital of Chongqing Medical University, Chongqing, China;Department of Pediatric General Surgery, Sanxia Hospital, Chongqing University, Chongqing, China;Department of Pediatric General and Neonatal Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China;Department of Traumatology, Children’s Hospital of Chongqing Medical University, Chongqing, China;Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China;

关键词: Roux-en-Y hepaticojejunostomy;    bile leakage;    redo surgery;    strict surgical repair;    children;   

DOI  :  10.3389/fsurg.2021.641127

来源: DOAJ

【 摘 要 】

Background: The optimal bile leakage management strategy in the pediatric population following the initial Roux-en-Y hepaticojejunostomy is still a matter of discussion today. Here, we assessed the roles of bile leakage management and surgical implementation on outcomes for patients with bile leakage.Materials and Methods: A revised protocol for bile leakage management with restricted surgical intervention was implemented at Chongqing Children’s Hospital on March 15, 2013 and Sanxia Hospital on April 20, 2013. We performed a retrospective, historical control analysis for the protocol implementation to compare the short- and long-term outcomes using the corresponding statistical methods.Results: There was a total of 84 patients included in the analysis, including 46 patients in the pre-protocol group and 38 patients in the post-protocol group. No statistical differences for the demographic features were found between the two groups. There was a decrease in redo surgeries in the post-protocol cohort compared to those in the pre-protocol cohort (odds ratio [OR] = 4.48 [95% CI, 1.57–12.77]; p = 0.003). Furthermore, patients in the post-protocol group were less likely to be associated with intensive care unit (ICU) admission (OR = 3.72 [95% CI, 1.11–12.49]; p = 0.024) compared to patients in the pre-protocol group, respectively. There was no mortality between the two groups.Conclusions: A restrictive surgical intervention strategy can effectively reduce the rate of redo surgery and exhibited promising outcomes for bile leakage in terms of postoperative recovery and hospitalization costs.

【 授权许可】

Unknown