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Background: Postoperative cholangitis is a common complication of pancreaticoduodenectomy. Frequent cholangitis impairs patients' quality of life after pancreaticoduodenectomy. However, the risk factors for recurrence of cholangitis remain unclear. Hence, this retrospective study aimed to identify risk factors for recurrence of cholangitis after pancreaticoduodenectomy.
Methods: The medical records of patients who underwent pancreaticoduodenectomy between 2015 and 2019 in our institution were retrospectively reviewed. At least two episodes of cholangitis a year after pancreaticoduodenectomy were defined as 'recurrence of cholangitis' in the present study. Univariate and multivariate analyses were performed.
Results: The recurrence of cholangitis occurred in 40 of 207 patients (19.3%). Multivariate analysis revealed that internal stent (external, RR: 2.16, P = 0.026; none, RR: 4.76, P = 0.011), firm pancreas (RR: 2.61, P = 0.021), constipation (RR: 3.49, P = 0.008), and postoperative total bilirubin>1.7 mg/dL (RR: 2.94, P = 0.006) were risk factors of recurrence of cholangitis. Among patients with internal stents (n = 54), those with remnant stents beyond 5 months had more frequent recurrence of cholangitis (≥5 months, 75%; <5 months, 30%).
Conclusions: Internal stents, firm pancreas, constipation, and postoperative high bilirubin levels are risk factors for cholangitis recurrence after pancreaticoduodenectomy. In addition, the long-term implantation of internal stents may trigger cholangitis recurrence.
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http://dx.doi.org/10.1007/s00268-023-07104-3 | DOI Listing |
Cureus
August 2025
Gastroenterology, Medica Superspecialty Hospital, Kolkata, IND.
Before the period of endoscopic retrograde cholangiopancreatography (ERCP), individuals with biliary tract diseases would undergo side-to-side choledochoduodenostomy, and sump syndrome used to develop as a complication of this procedure. There is retention of bile along with debris or calculi, and refluxed duodenal contents in the common bile duct, which leads to biliary and pancreatic complications. This syndrome's pathophysiology often results when the distal common bile duct below the anastomosis becomes a blind pouch (), leading to stasis of bile, food debris, and bacteria, which can lead to obstruction and infection.
View Article and Find Full Text PDFCureus
August 2025
Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, JPN.
Surgical clip migration to the common bile duct is a rare late complication, typically originating from clips placed at the cystic duct and most commonly reported after laparoscopic cholecystectomy. We present an exceptionally rare case of obstructive jaundice caused by clip migration from the liver dissection plane, rather than from the cystic duct, occurring 12 years after laparoscopic liver resection (LLR) and cholecystectomy and associated with chronic biliary inflammation. A 73-year-old man underwent LLR of segments 4a + 5 and cholecystectomy for hepatocellular carcinoma and was discharged on postoperative day 12 without any complications.
View Article and Find Full Text PDFAliment Pharmacol Ther
September 2025
Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Background And Aims: Primary sclerosing cholangitis (PSC) is a rare disease that paradoxically accounts for 5%-15% of liver transplants (LT). The paucity of liver donors is boosting living donor LT (LDLT). We reviewed the literature regarding outcomes of LT in PSC, comparing LDLT with deceased donor LT (DDLT).
View Article and Find Full Text PDFClin J Gastroenterol
September 2025
Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan.
We report a case of obstructive jaundice due to recurrent distal biliary stricture during 3 years of treatment for immunoglobulin G4 (IgG4)-related sclerosing cholangitis (IgG4-SC) associated with autoimmune pancreatitis. Although a relapse of IgG4-SC was initially suspected, imaging findings, laboratory tests, and histopathological examinations led to the diagnosis of metachronous cholangiocarcinoma. The patient underwent pancreaticoduodenectomy, and no cancer recurrence was noted 6 months postoperatively.
View Article and Find Full Text PDFCase Rep Gastroenterol
March 2025
Department of Medicine, Jaber Al-Ahmed Hospital, Kuwait City, Kuwait.
Introduction: Inflammatory bowel disease-primary sclerosing cholangitis (IBD-PSC) is a unique disease entity that has very poorly understood pathogenesis and unique clinical presentation. Patients with this disease may eventually require liver transplantation as there is no current curative treatment for PSC to halt disease progression for liver failure. Thirty percent of patients with IBD may experience recurrence despite being on immunosuppression.
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