Document Detail


Ileal pouch-anal anastomosis and liver transplantation for ulcerative colitis complicated by primary sclerosing cholangitis.
MedLine Citation:
PMID:  18496886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim was to evaluate outcomes in patients with ulcerative colitis complicated by primary sclerosing cholangitis (PSC) who required ileal pouch-anal anastomosis (IPAA) and orthotopic liver transplantation (OLT). METHODS: A retrospective analysis was performed of 32 patients undergoing both IPAA and OLT between 1980 and 2006. Data were collected regarding demographics, indication for surgery, postoperative complications, and outcome of IPAA and OLT. RESULTS: Thirty-day mortality after either procedure was nil. The median preoperative Model for End-stage Liver Disease (MELD) score for the group with initial IPAA was 8 (range 6-20) and the postoperative score was 11 (range 6-19). At 1 and 10 years, 32 and 26 of the 32 liver grafts had survived, and 31 and 30 of the 32 pouches, respectively. Fourteen patients require daily medical therapy for chronic pouchitis. At a median follow-up of 3.6 (range 0.2-16.2) years after the second of two procedures, responding patients reported a median of 5.5 stools per day and 2 stools per night. CONCLUSION: IPAA and OLT are feasible and safe in patients requiring both procedures for ulcerative colitis and PSC. Functional outcomes are stable over time, despite an increased risk of chronic pouchitis.
Authors:
K L Mathis; E J Dozois; D W Larson; R R Cima; J M Sarmiento; B G Wolff; J K Heimbach; J H Pemberton
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  95     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-19     Completed Date:  2008-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  882-6     Citation Subset:  AIM; IM    
Copyright Information:
(c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Mayo Clinic, Department of Surgery, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anal Canal / surgery*
Anastomosis, Surgical
Cholangitis, Sclerosing / complications*
Colitis, Ulcerative / complications*,  surgery
Colonic Pouches*
Disease-Free Survival
Feasibility Studies
Female
Humans
Liver Transplantation*
Male
Middle Aged
Pouchitis / etiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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