Abstract
Background Primary intrahepatic lithiasis is defined by the presence of gallstones at the level of cystic dilatations
of the intrahepatic biliary tree. Liver resection is considered the treatment of choice, with the purpose of removing
stones and atrophic parenchyma, also reducing the risk of cholangiocarcinoma. However, in consequence of the
considerable incidence of infectious complications, postoperative morbidity remains high. The current study was
designed to evaluate the impact of preoperative bacterial colonization of the bile ducts on postoperative outcome.
Methods The clinical records of 73 patients treated with liver resection were reviewed and clinical data, operative
procedures, results of bile cultures, and postoperative outcomes were examined.
Results Left hepatectomy (38 patients) and left lateral sectionectomy (19 patients) were the most frequently
performed procedures. Overall morbidity was 38.3 %. A total of 133 microorganisms were isolated from bile.
Multivariate analysis identified previous endoscopic or percutaneous cholangiography (p = 0.043) and preoperative
cholangitis (p = 0.003) as the only two independent risk factors for postoperative infectious complications.
Conclusions Postoperative morbidity was strictly related to the preoperative biliary infection. An effective control
of infections should be always pursued before liver resection for intrahepatic stones and an aggressive treatment of
early signs of sepsis should be strongly emphasized.
Lingua originale | English |
---|---|
pagine (da-a) | 433-439 |
Numero di pagine | 7 |
Rivista | World Journal of Surgery |
Volume | 40 |
DOI | |
Stato di pubblicazione | Pubblicato - 2016 |
Keywords
- Cholangitis
- Liver resection
- Postoperative infectious complications
- Primary intrahepatic stones