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Correlations of portal pressure in post‐cholecystectomy benign biliary stricture
Author(s) -
Nag Hirdaya H.,
Arora Asit,
Tyagi Ila,
Ramaswamy Dinesh,
Patil Nilesh,
Sakhuja Puja,
Saha Renuka,
Agarwal Anil K.
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12463
Subject(s) - medicine , gastroenterology , rank correlation , perioperative , spearman's rank correlation coefficient , portal hypertension , cholecystectomy , complication , correlation , surgery , cirrhosis , mathematics , statistics , geometry
Aim Presence of portal hypertension ( PH ) adversely affects perioperative and long‐term outcome in patients with post‐cholecystectomy benign biliary stricture ( PCBBS ). Identification of factors related to the development of PH will help to prevent this complication. Methods From S eptember 2010 to D ecember 2012, 30 patients with PCBBS were studied prospectively for correlation of portal pressure ( PP ) with injury repair interval ( IRI ), biliary pressure ( BP ), severity of hepatic fibrosis ( FS ), severity of hepatic inflammation ( IS ) and obstructive biliary pathology score ( OBPS ). Appropriate statistical methods employed and P ≤ 0.05 (two‐sided) was considered statistically significant. Results Mean PP , mean BP and median IRI were 19.4 ± 4.74 mmHg, 20.1 ± 3.99 mmHg and 145 days, respectively. Spearman's rank correlation coefficients ( P ‐ value) of PP with IRI , FS , IS and OBPS were 0.564 (0.001), 0.502 (0.004), 0.752 (0.0001) and 0.242 (0.19), respectively. Pearson correlation of PP with BP was r = 0.383 ( r 2 = 0.146, P = 0.03). Spearman's rank correlation coefficients ( P ‐value) of FS with IS and OBPS were 0.561 (0.003) and 0.371 (0.04), respectively. Spearman's rank correlation coefficient of serum bilirubin with OBPS was 0.550 ( P = 0.001). Incidence of PH was 33.3% and mean fall of PP following biliary repair was 6.2 ± 1.98 mmHg ( P < 0.0001). Conclusion PP in patients with PCBBS has a good correlation with IS , and a fair correlation with both FS and IRI whereas PP was not directly related to BP and OBPS ; further prospective trials are mandatory to confirm this correlation, and to evaluate mechanism of fall in PP following biliary decompression.