Early complications after biliary enteric anastomosis for benign diseases: A retrospective analysis

We reviewed the medical records of all patients who underwent BEA for benign diseases at our institution between January 1988 and December 2009. The primary outcome was early post operative complication. Logistic regression analysis was done to identify factors predicting the occurrence of complications.Records of 79 patients were reviewed. There were 34 (43%) males and 45 (57% females). Majority (53%) had choledocholithiasis with impacted stone or distal stricture, followed by traumatic injury to the biliary system (33%). Thirty-four patients (43%) underwent a hepaticojejunostomy, 19 patients (24%) underwent a choledochojejunostomy, and choledochoduodenostomy was performed in 26 patients (33%). Early complications occurred in 39 (49%) patients - 41% had local complications and 25% had systemic complications. Most frequent complications were wound infection (23%) and bile leak (10%). Four (5%) patients died. On multivariate analysis, low serum albumin level (odds ratio = 16, 95% CI = 1.14-234.6) and higher ASA levels (odds ratio = 7, 95% CI: 1.22-33.34) were the independent factors predicting the early complications following BEA.Half of the patients who underwent BEA for benign diseases had complications in our population. This high incidence may be explained by the high incidence of hypoalbuminemia and the high-risk group who underwent operation.Biliary-enteric anastomosis (BEA) is a common surgical procedure performed for a variety of indications. This includes bypass or reconstruction following resection of malignant or benign biliary obstruction, primary biliary stones, iatrogenic bile duct injury, liver transplantation; and a number of biliary tract problems that are benign but have malignant potential such as primary sclerosing cholangitis, choledochal cyst, and hepatolithiasis. Surgical options for these diverse conditions include hepaticojejunostomy, choledochoenterostomies and cholecystoenterostomies. Biliary-enteric surgery is an essential surgical proced