TY - JOUR
T1 - Risk Factors for Cholangitis After Pancreatoduodenectomy
T2 - A Systematic Review
AU - Salaheddine, Youcef
AU - Henry, Anne Claire
AU - Daamen, Lois A
AU - Derksen, Wouter J M
AU - van Lienden, Krijn P
AU - Molenaar, I Quintus
AU - van Santvoort, Hjalmar C
AU - Vleggaar, Frank P
AU - Verdonk, Robert C
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/7
Y1 - 2023/7
N2 - BACKGROUND: Cholangitis is a late complication after pancreatoduodenectomy with considerable clinical impact and is difficult to treat. The aim of this systematic review was to provide an overview of the literature identifying risk factors for postoperative cholangitis.METHODS: A systematic search of the databases PUBMED and EMBASE was performed to identify all studies reporting on possible risk factors for cholangitis following pancreatoduodenectomy. Data on patient, peri- and postoperative characteristics were collected. Risk of bias assessment was done according to the methodological index for non-randomized studies (MINORS) criteria.RESULTS: In total, 464 studies were identified. Eight studies met the inclusion criteria for this analysis. The definition of postoperative cholangitis was inconsistent, with four studies using the Tokyo Guidelines, whereas other studies used different definitions. Data on 26 potential risk factors concerning the patient, peri- and postoperative characteristics were analyzed. Five factors were significantly associated with cholangitis in two or more studies: high body mass index, duration of surgery, benign disease, postoperative pancreatic fistula, and postoperative serum alkaline phosphatase.CONCLUSION: Multiple potential risk factors for postoperative cholangitis were identified, with large discrepancies between studies. Prospective research, with consensus on the definition, is required to determine the true relevance of these risk factors.
AB - BACKGROUND: Cholangitis is a late complication after pancreatoduodenectomy with considerable clinical impact and is difficult to treat. The aim of this systematic review was to provide an overview of the literature identifying risk factors for postoperative cholangitis.METHODS: A systematic search of the databases PUBMED and EMBASE was performed to identify all studies reporting on possible risk factors for cholangitis following pancreatoduodenectomy. Data on patient, peri- and postoperative characteristics were collected. Risk of bias assessment was done according to the methodological index for non-randomized studies (MINORS) criteria.RESULTS: In total, 464 studies were identified. Eight studies met the inclusion criteria for this analysis. The definition of postoperative cholangitis was inconsistent, with four studies using the Tokyo Guidelines, whereas other studies used different definitions. Data on 26 potential risk factors concerning the patient, peri- and postoperative characteristics were analyzed. Five factors were significantly associated with cholangitis in two or more studies: high body mass index, duration of surgery, benign disease, postoperative pancreatic fistula, and postoperative serum alkaline phosphatase.CONCLUSION: Multiple potential risk factors for postoperative cholangitis were identified, with large discrepancies between studies. Prospective research, with consensus on the definition, is required to determine the true relevance of these risk factors.
KW - Cholangitis
KW - Hepaticojejunostomy
KW - Pancreatoduodenectomy
KW - Risk factor
UR - http://www.scopus.com/inward/record.url?scp=85151984092&partnerID=8YFLogxK
U2 - 10.1007/s10620-023-07929-x
DO - 10.1007/s10620-023-07929-x
M3 - Review article
C2 - 37024745
SN - 0163-2116
VL - 68
SP - 3158
EP - 3166
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 7
ER -