Risk factors associated with anastomotic leak in patients undergoing biliodigestive bypass surgery secondary to bile duct disruption
Eduardo F. Constantino-Corzo 1 
, Jonatan Ramírez-Castañeda 1 , Carlos A. López-Bernal 2 , Álvaro J. Montiel-Jarquín 3 , Nancy R. Bertado-Ramírez 4 , Arturo García-Galicia 4 , Angélica Porras-Juárez 5 , Susana Barrera-Hernández 6
1 Departamento de Cirugía General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Pue., México; 2 Department of Coloproctology. High Specialty Medical Unit Hospital de Especialidades, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, IMSS. Puebla de Zaragoza, Puebla, Mexico; 3 Dirección de Educación e Investigación en Salud, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 4 Dirección de Educación e Investigación en Salud. Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Pue., México; 5 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 6 Departamento de Medicina Interna, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, 2Departamento de Medicina Interna, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social
*Correspondence: Nancy R. Bertado-Ramírez. Email: nancy.bertado@imss.gob.mx
Abstract
Background: Cholecystectomy is a surgery that can have bile duct injury as a complication. Its management is a biliodigestive diversion which may present bile leak.
Objective: To describe risk factors associated with anastomotic leak in patients undergoing biliodigestive bypass surgery.
Material and methods: comparative study, cause-effect in patients who underwent biliodigestive bypass surgery from March 2021 to March 2024. Data were collected from the clinical file, the variables were: sex, age, type of biliodigestive bypass, BMI, CONUT, comorbidities, and days of hospital stay.
Results: There were 48 patients. Maximum age 82, minimum 21 and average 45 years. Predominant sex was women (72%), the most used surgical technique was intrahepatic shunts (56.3%), BMI less than 18.4 and greater than 25 (70.8%), nutritional deficit range according to CONUT, 91.7%. There was fistula in 54.2%, low output in 45.33%. The main management was conservative (47.9%).
Conclusions: The variables studied were not risk factors for fistula in patients undergoing biliodigestive anastomosis (OR < 1.0; 95% CI < 1.0), the type of diversion increases the hospital stay.
