Ítem
Acceso Abierto
Omental patch as prevention for bile leak in patients undergoing subtotal cholecystectomy: a propensity score analysis
Título de la revista
Autores
Isaza Restrepo, Andrés
Díaz‑Castrillón, Juan Felipe
Van‑Londoño, Isabella
González‑Muñoz, Alejandro
Avendaño‑Morales, Violeta
Ramirez Giraldo, Camilo
Fecha
2025-02-11
Directores
ISSN de la revista
Título del volumen
Editor
Springer Nature Link
Buscar en:
Métricas alternativas
Resumen
Abstract
Subtotal cholecystectomy is one of the most frequent bail-out procedures performed during difcult cholecystectomy. A common complication to this procedure is bile leak, and thus multiple strategies have been created to avoid its appearance. This study aims to evaluate the efectivity of using an omental patch as bile leak prevention in patients undergoing subtotal cholecystectomy. A retrospective cohort study including patients who underwent subtotal cholecystectomy between 2014 and 2022 was performed. 17 patients had an omental patch, while 378 did not; the latter were included to evaluate surgical outcomes with bile leak as a primary outcome using a propensity score matching analysis (PSM). Patients’ median age in both groups after PSM was 71.00 (IQR: 59.00–81.00) and 69.00 (IQR: 61.75–80.25) years, respectively. The dominant sex in both groups was male. In most cases surgical procedure indication was cholecystitis. Patients who had an omental patch did not present statistically signifcant diferences for bile leak rates compared to patients who did not (29.4% versus 17.6%, p=0.456, respectively). Similar results were observed when evaluating the need for postoperative ERCP for bile leak management (23.5 versus 5.9%, p=0.078). A statistically signifcant higher proportion of major complications were observed in patients who had an omental patch (47.1% versus 19.1%, p=0.038). Pedicled omental patch was not an efective measure for preventing bile leak, and it even presented a higher rate of complications. It is thus imperative to continue evaluating other strategies for the prevention of bile leak during subtotal cholecystectomy.
Palabras clave
Keywords
Cholecystectomy , Subtotal cholecystectomy , Laparoscopic , Cholecystitis , Bile leak
