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

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World Journal of Gastrointestinal Surgery 2023年第2期15卷 234-248页

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 Department of General Surgery Faculty of MedicineZagazig UniversityZagazig 44759SharkiaEgypt Homerton University Hospital London E96SRUK Department of Surgical Science University of CagliariCagliari 2432Italy Department of Medical and Surgical Sciences Universitàdegli studi di FoggiaFoggia 546Italy MD CQInsights PBC Co-founder&CEOTennesseeTN 37010United States Department of Internal Medicine Zagazig UniversityZagazig 2355Egypt Department of Internal Medicine Suez UniversitySuez 235Egypt Department of General Surgery Faculty of Medicine-Merit UniversitySohag 82511Egypt Department of General Surgery Al-azhar UniversityCairo 285Egypt Department of Hepato-Bilio-Pancreatic(HBP)Surgery National Hepatology and Tropical Medicine Research InstituteCairo 285Egypt Department of General Surgery Mataryia Teaching HospitalCairo 285Egypt

BACKGROUND Hepatobiliary manifestations occur in ulcerative colitis(UC)*** effect of laparoscopic restorative proctocolectomy(LRP)with ileal pouch anal anastomosis(IPAA)on hepatobiliary manifestations is *** To evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with *** Between June 2013 and June 2018,167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational *** with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the *** patients were followed up for four years to assess the outcomes of hepatobiliary *** 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 *** or regressive courses occurred in 16.8%of *** 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 ***-thirds(64.3%)of fatty liver patients showed a regressive course,while one-third(35.7%)showed a stable *** rates were 98.8%,97%,95.8%,and 94%at 12 mo,24 mo,36 mo,and at the end of the *** In patients with UC who had LRP,there is a positive impact on hepatobiliary *** caused an improvement in PSC and fatty liver *** 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

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