ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
Defining treatment and outcomes of hepaticojejunostomy failure following pancreaticoduodenectomy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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35 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Sarcopenia as a prognostic marker in patients undergoing pancreaticoduodenectomy: an updated meta-analysis.Frontiers in oncology · 2025Pooled it
- Hepaticojejunostomy Insufficiency-Associated Arterial Hemorrhage in Patients After Pancreatic Surgery.Journal of clinical medicine · 2026Article
- Postoperative Cholangitis After Pancreatoduodenectomy: A Frequent Late Complication Demanding Standardized Prevention and Treatment Protocols.Annals of surgical oncology · 2025Article
- Imaging and management of complications post biliary-enteric anastomosis.Abdominal radiology (New York) · 2025Review
- Efficacy of preoperative endoscopic nasobiliary drainage tube placement for liver cancer adjacent to the hepatic hilum.Langenbeck's archives of surgery · 2025Article
- Machine learning-based prediction of postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.BMC surgery · 2025Article
- The establishment and validation of a clinical prediction model for postoperative biliary fistula after pancreaticoduodenectomy.Gland surgery · 2024Article
- Early postoperative fever as a predictor of pancreatic fistula after pancreaticoduodenectomy: a single-center retrospective observational study.BMC surgery · 2024Observational
- How to integrate robotic training in surgical residency? An example of a 2-week robotic rotation.Journal of robotic surgery · 2024Article
- How to do it: rescue duct-to-duct biliary reconstruction techniques to avoid severe biliary complications of hepatic resection for hepatocellular carcinoma.Surgery today · 2024Review
- [Endoscopic management of complications in the hepatobiliary and pancreatic system and the tracheobronchial tree].Chirurgie (Heidelberg, Germany) · 2023Article
- Surgical Treatment of Distal Cholangiocarcinoma.Current oncology (Toronto, Ont.) · 2022Review
- Effect of postoperative non-steroidal anti-inflammatory drugs on anastomotic leakage after pancreaticoduodenectomy.Korean journal of anesthesiology · 2022Article
- Laparoscopic common bile duct exploration with primary closure is beneficial for patients with previous upper abdominal surgery.Surgical endoscopy · 2022Article
- Expanding endoscopic treatment strategies for pancreatic leaks following pancreato-duodenectomy: a single centre experience.Surgical endoscopy · 2021Article
- Transient Biliary Fistula After Pancreatoduodenectomy Increases Risk of Biliary Anastomotic Stricture.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Patterns of Failure and the Need for Biliary Intervention in Resected Biliary Tract Cancers After Chemoradiation.Annals of surgical oncology · 2020Article
- Leakage and Stenosis of the Hepaticojejunostomy Following Surgery for Perihilar Cholangiocarcinoma.Journal of clinical medicine · 2020Article
- A Modified Suture Technique in Hepaticojejunostomy.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Duodeno-jejunal or gastro-enteric leakage after pancreatic resection: a case-control study.Updates in surgery · 2019Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe overall complication rate after pancreaticoduodenectomy (PD) approaches 50 %, with anastomotic failure being the most frequent cause of serious postoperative morbidity. Hepaticojejunostomy leaks (also called bile leaks) are the second most common type of leak, behind pancreaticojejunostomy leaks, yet have been the focus of only a single study as reported by Suzuki et al. (Hepatogastroenterology 50:254-257, 12).
methodsWe reviewed the recent experience with bile leaks at a single, high-volume pancreatic surgery center over a six-year time period.
resultsBile leaks were identified in 16 out of 715 patients (2.2 %). Low preoperative albumin was associated with an increased risk. Bile leaks typically manifested within the first week after surgery as bilious drainage in a surgically placed drain. Associated warning signs included fever and leukocytosis. Patients with a bile leak frequently developed other complications, including a pancreatic fistula, wound infection, delayed gastric emptying, and sepsis. The impact on perioperative outcomes was comparable to patients with a pancreatic leak. A grading system is proposed based on the International Study Group on Pancreatic Fistula model. Grade A bile leaks were classified as those managed with prolonged drainage by operatively placed drains, grade B bile leaks with percutaneous abdominal drainage, and grade C bile leaks with insertion of a percutaneous transhepatic biliary drainage.
conclusionsHepaticojejunostomy leaks are rare after PD. The complication severity ranges from trivial to life threatening and is comparable overall to pancreaticojejunostomy leaks. Surgical intervention is rarely, if ever, required. With prompt and aggressive management, a full recovery can be expected.
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