[Quality of life of patients who underwent a bile duct reconstruction]

BACKGROUND

Bile duct reconstruction (BDR) secondary to bile duct injury during cholecystectomy (BDIC) is a complex surgery, and an important issue is the quality of life (QL) after the procedure.

AIM

To compare the QL of a cohort of patients who underwent BDR due to BDIC with a cohort of patients who underwent a cholecystectomy without incidents.

MATERIAL AND METHODS

The cohort was composed of 32 patients aged 47 ± 18 years (78% women) who underwent BDR due to BDIC. For purposes of comparison, a cohort of patients who underwent a cholecystectomy without incident was chosen. These cohorts were paired 1:1 by age (± 1 year), gender and type of surgery. The SF-36 quality of life survey was applied in person or by telephone. The score was calculated as proposed by the RAND group.

RESULTS

The cohort of BDR patients was comprised of 32 patients, with an average age of 47 ± 17.6 years, with a predominance of women (78%). The mean number of hospitalization days among BDR patients was 20 ± 11.8. The average follow-up was 7 ± 5 years. The mean score of patients undergoing RVB or cholecystectomy without complications was evaluated, without finding differences in the score of the different domains of the SF-36 scale.

CONCLUSIONS

In the present study no significant differences were found in QL between the patients with BDIC who underwent BDR and patients who underwent a cholecystectomy without complications.

[Hepatocarcinoma with sarcomatoid transformation: case report]

Hepatocarcinoma with sarcomatoid transformation is uncommon. It presents clinically with inverted exclamation markeucocytosis and fever, resembling a liver abscess. We report a 40 year-old male that presented pain in the right upper quadrant and fever. Abdominal imaging showed an hypodense image in the liver that resembled a liver abscess. The patient was subjected to a percutaneous drainage obtaining 150 ml of an hemorrhagic fluid whose culture was negative. The clinical picture persisted and the patient was subjected to a right hepatectomy. The pathological study of the surgical piece disclosed a hepatocarcinoma with sarcomatoid transformation. The patient was discharged sixteen days after surgery.