Long-term results of major XXXX associated with laparoscopic cholecystectomy.

@entity1 @entity32 @entity1157 @entity253
BACKGROUND: @entity1157 ( @entity1157 ) is the most serious complication associated with laparoscopic cholecystectomy (LC). This study reports on long-term outcomes and clinical factors which predicted the outcome of 25 @entity1 with LC-associated @entity1157 . METHODS: Twenty-five consecutive @entity1 receiving either primary (n = 11) or redo (n = 14) biliary reconstructive surgery at Cathay General Hospital for LC-associated @entity1157 were prospectively followed for 2 to 10 (mean, 4.5) years to assess their long-term outcomes. Twelve clinical factors relevant to their outcomes were analyzed. RESULTS: There was no mortality. Although the 1-year postoperative results were successful in 23 @entity1 (92%), the mid- to long-term outcomes were successful in only 17 @entity1 (68%). Eight @entity1 (32%) developed @entity253 at an average of 3.3 years postoperatively and required subsequent reoperation or biliary stenting. Statistical comparison of 12 risk factors between the successful and unsuccessful groups revealed that two were significant, namely, repair performed by a nonreferral surgeon (p = 0.02) and repair at a stage with recent active @entity32 (p = 0.04). A serum alkaline phosphatase level greater than 400 IU in the sixth postoperative month was highly correlated with long-term nonsuccess (p = 0.01). CONCLUSIONS: Only 68% of @entity1 with LC-associated @entity1157 who underwent reconstructive surgery at our institution had long-term success. A serum alkaline phosphatase level above 400 IU in the sixth postoperative month was predictive of nonsuccess. For better long-term results, repair should be performed by the referral surgeon at a stage without coexisting active @entity32 .
