Our Summary

This research paper investigates the effects and costs of a condition known as delayed biliary strictures (DBS) that can occur after a gallbladder removal surgery (cholecystectomy). DBS is rare and not much is known about why it happens or what the long-term effects are.

The research looked at patients who developed DBS after having their gallbladder removed and studied the factors that increased the risk of developing the condition, the impact on the patients’ quality of life, and the rate of other complications related to the bile duct. They also looked at the costs of treating DBS and of follow-up care.

They found that DBS usually happens after a complicated gallbladder surgery. The study showed that around 40% of the patients needed surgery to treat DBS. Over almost 9 years of follow-up, about 36% of these patients developed complications related to the bile duct, and one patient died due to problems related to DBS.

The cost of treating DBS and of follow-up care was around £14,309.26 per patient, which was similar to the previously reported costs for major injuries to the bile duct (£15,784).

In conclusion, the study showed that the clinical outcomes, cost, and impact on quality of life of patients with DBS are similar to those of patients with major injuries to the bile duct.

FAQs

  1. What are delayed biliary strictures (DBS) that can occur after a cholecystectomy?
  2. What are the long-term complications and economic impact of DBS after a cholecystectomy?
  3. How does the impact of DBS compare to patients with minor or major bile duct injury (BDI)?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cholecystectomy is to follow a healthy diet and lifestyle post-surgery to prevent any complications such as delayed biliary strictures. It is important to stay hydrated, avoid fatty and fried foods, and maintain a balanced diet to support digestion and overall health. Regular exercise and weight management can also help reduce the risk of developing complications after cholecystectomy. It is important to follow up with your healthcare provider for regular check-ups and monitoring to ensure a successful recovery.

Suitable For

Patients who are typically recommended cholecystectomy include those with symptomatic gallstones, gallbladder inflammation (cholecystitis), gallbladder polyps, or biliary dyskinesia. In some cases, patients with a history of recurrent gallbladder attacks or complications such as pancreatitis may also be recommended for cholecystectomy. Additionally, patients with suspected or known gallbladder cancer may require cholecystectomy as part of their treatment plan.

Timeline

Before cholecystectomy:

  • Patient experiences symptoms such as gallstones, biliary colic, nausea, and abdominal pain.
  • Patient undergoes diagnostic tests such as ultrasound, CT scan, and blood tests to confirm the need for cholecystectomy.
  • Surgery is scheduled and pre-operative instructions are provided to the patient.

After cholecystectomy:

  • Patient undergoes surgery and is monitored in the recovery room before being discharged home.
  • Patient may experience pain, swelling, and discomfort at the surgical site.
  • Follow-up appointments are scheduled to monitor healing and discuss any complications.
  • In some cases, delayed biliary strictures (DBS) may develop after cholecystectomy, leading to additional symptoms and complications.
  • Treatment for DBS may involve surgical intervention and long-term follow-up to monitor for biliary complications.
  • The patient’s quality of life, clinical outcomes, and economic impact of DBS are similar to those with major bile duct injury.

What to Ask Your Doctor

  1. What are the potential risks and complications of cholecystectomy, including the development of delayed biliary strictures?

  2. What are the signs and symptoms of a delayed biliary stricture, and when should I seek medical attention if I suspect I may have one?

  3. How is a delayed biliary stricture diagnosed, and what tests or imaging studies may be necessary to confirm the diagnosis?

  4. What are the treatment options for a delayed biliary stricture, and what is the likelihood of needing surgical intervention?

  5. What is the long-term outlook for patients who have had a delayed biliary stricture, and what are the chances of developing further biliary complications in the future?

  6. How often will I need to follow up with my healthcare provider after treatment for a delayed biliary stricture, and what ongoing monitoring may be necessary?

  7. What are the potential costs associated with treating a delayed biliary stricture, including any surgical procedures or follow-up care that may be required?

  8. Are there any specific factors that may increase my risk of developing a delayed biliary stricture after cholecystectomy, and are there any steps I can take to reduce this risk?

Reference

Authors: Halle-Smith JM, Marudanayagam R, Mirza DF, Roberts KJ. Journal: HPB (Oxford). 2022 Feb;24(2):209-216. doi: 10.1016/j.hpb.2021.06.416. Epub 2021 Jun 24. PMID: 34294526