Results of surgical treatment of cicatricial stenosis of biliary structures

Abstract

Treatment of biliary stenosis secondary to iatrogenic lesion is complex and often requires a multidisciplinary approach. The golden standard for definitive correction of biliary stenosis is surgery, which presents good results when performed in specialized centers. Objective: To assess the results of surgical treatment of patients with iatrogenic lesion of biliary ducts. Methods: Patients submitted to surgical correction of iatrogenic bile duct injury from 1990 to 2016 will be retrospectively evaluated. Patient data will be collected from medical records and from the electronic database HCMED. The following parameters will be assessed: 1) clinical data: age, sex, race, weight, height, ECOG, Karnofsky, previous treatments, episodes of cholangitis, jaundice or biliary fistula, surgical risk, comorbidities, characterization of the biliary lesion, date of surgery, description of the surgery, postoperative complications, date of discharge, new admissions, reoperations, disease recurrence, liver transplant indication, date of the last appointment, date and cause of death (if applicable); 2) pre and postoperative radiologic exams, liver biopsy, AST, ALT, alkaline phosphatase, GGT, bilirubin and platelets. Statistical analysis: Comparisons between two groups will be performed using Student t test, Mann-Whitney test or Chi-square test. We will analyze the variables associated with disease recurrence and patient survival. Survival will be analyzed using the Kaplan-Meier method and survival curves will be compared by the long-rank test. Univariate and multiple logistic regression analysis will be performed to identify factors of poor prognosis.