Clinical characteristics of and risk factors for hepatolithiasis developed after surgery for congenital biliary dilatation

Table 1 Background characteristics of patients with congenital biliary dilatation who underwent extrahepatic bile duct resection, n (%)

Characteristics	Study sample (n = 223)
Male/female	70 (31)/153 (69)
Age at surgery (year), median (range)	5.2 (0.07-77)
Child/adult	164 (74)/59 (26)
Todani classification
Ia	79 (35)
Ic	52 (23)
IV-A	92 (41)
Preoperative conditions
Symptoms1	183 (82)
Stones in bile tract	98 (44)

¹Symptoms include abdominal pain, nausea, vomiting, an abdominal mass, and jaundice.

Table 2 Short-term and long-term complications after extrahepatic bile duct resection for congenital biliary dilatation, n (%)

Characteristics	Short-term (n = 42)		Long-term (n = 37)
	Child (n = 23)	Adult (n = 19)	Child (n = 12)	Adult (n = 25)
Male/female	7 (30)/16 (70)	8 (42)/11 (58)	3 (25)/9 (75)	9 (36)/16 (64)
Age at surgery (year), median (interquartile range)	1.9 (4.2)	45.0 (20.0)	3.8 (5.9)	50.0 (31.0)
Todani classification
Ia	9 (39)	5 (26)	3 (25)	10 (40)
Ic	4 (17)	3 (16)	3 (25)	4 (16)
IV-A	10 (43)	11 (58)	6 (50)	11 (44)
Complications
Anastomotic leakage	11 (48)	3 (16)	0 (0)	0 (0)
Surgical site infection	4 (17)	4 (21)	0 (0)	0 (0)
Acute cholangitis	1 (4)	4 (21)	3 (25)	23 (92)
Delayed gastric emptying	4 (17)	1 (5)	0 (0)	0 (0)
Intra-abdominal abscess	1 (4)	3 (16)	0 (0)	0 (0)
Pancreatic fistula	1 (4)	2 (11)	0 (0)	0 (0)
Anastomotic stenosis	1 (4)	0 (0)	1 (8)	7 (28)
Intestinal obstruction	1 (4)	0 (0)	6 (50)	1 (4)
Acute pancreatitis	1 (4)	0 (0)	3 (25)	2 (8)
Hepatolithiasis	0 (0)	0 (0)	2 (17)	13 (52)
Pancreatic stones	0 (0)	0 (0)	0 (0)	3 (8)
Biliary cirrhosis	0 (0)	0 (0)	0 (0)	2 (5)
Bile tract cancer	0 (0)	0 (0)	0 (0)	0 (0)

Table 3 Characteristics of patients with or without hepatolithiasis after extrahepatic bile duct resection, n (%)

Characteristics	HL (n = 15)	Without HL (n = 208)
Male/female	5 (33)/10 (67)	65 (31)/143 (69)
Todani classification
Ia	5 (33)	74 (36)
Ic	3 (20)	49 (24)
Ia or Ic	8 (53)	123 (59)
IV-A	7 (47)	85 (41)
Age at surgery (year), median (IQR)	55.0 (22.7)	12.5 (16.7)
Child/adult	2 (13)/13 (87)	161 (77)/47 (23)
Preoperative condition
Stones in bile tract	3 (20)	95 (46)
With symptoms	8 (53)	175 (84)
Postoperative observation period (year), median (IQR)	14.5 (8.8)	10.0 (10.0)
Postoperative short-term complications
All	4 (27)	38 (18)
Anastomotic leakage	0 (0)	14 (7)
Acute cholangitis	2 (13)	3 (1)
Anastomotic stenosis	0 (0)	1 (0.5)
Intra-abdominal abscess	0 (0)	4 (2)
Pancreatic fistula	0 (0)	3 (1)
Acute pancreatitis	0 (0)	1 (0.5)
Clavien-Dindo classification ≥ 3	1 (7)	12 (6)
Postoperative long-term complications
Anastomotic stenosis	5 (33)	3 (1)
Acute pancreatitis	0 (0)	5 (2)

HL: Hepatolithiasis; IQR: Interquartile range.

Table 4 Multivariate Cox proportional regression analysis

Variables	Hazard ratio	95%CI
Age at surgery	1.028	1.0-1.0448
Todani type Ic	1.0	1.0-1.0000
Todani type IV-A	1.0	1.0-1.0000
Preoperative conditions
Stones in bile tract	1.0	1.0-1.0000
Symptoms	1.0	1.0-1.0000
Short-term complications
Acute cholangitis	1.0	1.0-5.8948
Anastomotic leakage	1.0	1.0-1.0000