Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis:A prospective observational study  

作　　者：Tamer A A M Habeeb Abdulzahra Hussain Mauro Podda Pasquale Cianci Bruce Ramshaw Khaled Safwat Wesam M Amr Tamer Wasefy Alaa A Fiad Mohamed Ibrahim Mansour Adel Mahmoud Moursi GamalOsman Anass Qasem Mohamed Fawzy Mohamed Ibrahim Abo Alsaad Abd-Elfattah Kalmoush MohammedShaaban Nassar Fawzy M Mustafa Mahmoud Hassib Morsi Badawy Ahmed Hamdy Hamdi Elbelkasi Bassam Mousa Abd-Elrahman M Metwalli Walid A Mawla Mostafa M Elaidy Muhammad Ali Baghdadi Ahmed Raafat 

机构地区：[1]Department of General Surgery,Faculty of Medicine,Zagazig University,Zagazig 44759,Sharkia,Egypt [2]Homerton University Hospital,London E96SR,UK [3]Department of Surgical Science,University of Cagliari,Cagliari 2432,Italy [4]Department of Medical and Surgical Sciences,Universitàdegli studi di Foggia,Foggia 546,Italy [5]MD CQInsights PBC,Co-founder&CEO,Tennessee,TN 37010,United States [6]Department of Internal Medicine,Zagazig University,Zagazig 2355,Egypt [7]Department of Internal Medicine,Suez University,Suez 235,Egypt [8]Department of General Surgery,Faculty of Medicine-Merit University,Sohag 82511,Egypt [9]Department of General Surgery,Al-azhar University,Cairo 285,Egypt [10]Department of Hepato-Bilio-Pancreatic(HBP)Surgery,National Hepatology and Tropical Medicine Research Institute,Cairo 285,Egypt [11]Department of General Surgery,Mataryia Teaching Hospital,Cairo 285,Egypt

出　　处：《World Journal of Gastrointestinal Surgery》2023年第2期234-248,共15页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Hepatobiliary manifestations occur in ulcerative colitis(UC)patients.The effect of laparoscopic restorative proctocolectomy(LRP)with ileal pouch anal anastomosis(IPAA)on hepatobiliary manifestations is debated.AIM To evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC.METHODS Between June 2013 and June 2018,167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study.Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study.The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations.RESULTS The patients'mean age was 36±8 years,and males predominated(67.1%).The most common hepatobiliary diagnostic method was liver biopsy(85.6%),followed by Magnetic resonance cholangiopancreatography(63.5%),Antineutrophil cytoplasmic antibodies(62.5%),abdominal ultrasonography(35.9%),and Endoscopic retrograde cholangiopancreatography(6%).The most common hepatobiliary symptom was Primary sclerosing cholangitis(PSC)(62.3%),followed by fatty liver(16.8%)and gallbladder stone(10.2%).66.4%of patients showed a stable course after surgery.Progressive or regressive courses occurred in 16.8%of each.Mortality was 6%,and recurrence or progression of symptoms required surgery for 15%.Most PSC patients(87.5%)had a stable course,and only 12.5%became worse.Two-thirds(64.3%)of fatty liver patients showed a regressive course,while one-third(35.7%)showed a stable course.Survival rates were 98.8%,97%,95.8%,and 94%at 12 mo,24 mo,36 mo,and at the end of the follow-up.CONCLUSION In patients with UC who had LRP,there is a positive impact on hepatobiliary disease.It caused an improvement in PSC and fatty liver disease.The most prevalent unchanged course was PSC,while the most common improvement was fatty liver disease.

关 键 词：COURSES Hepatobiliary manifestations Primary sclerosing cholangitis Restorative proctocolectomy 

分 类 号：R656.9[医药卫生—外科学]