Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
6.0
3.4
Journals
Life
Special Issues
Advancements in Postoperative Management of Patients After Surgery
share announcement

Advancements in Postoperative Management of Patients After Surgery

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (30 September 2025) | Viewed by 13477

Special Issue Editors

Dr. Antonino Zanghi

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
Interests: surgery; robotics; pain management; general surgery
Dr. Luigi La Via

E-Mail Website
Guest Editor
Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy
Interests: loco-regional anesthesia; pain medicine; ERAS
Special Issues, Collections and Topics in MDPI journals
Dr. Antonino Maniaci

E-Mail Website
Guest Editor
Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
Interests: audiology; otology; artificial intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Alessandro Cappellani

E-Mail Website
Guest Editor
Department of Surgery, General Surgery and Breast Unit, University of Catania, Catania, Italy
Interests: general surgery; postoperative outcomes; microsurgery; robotics

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore the latest advancements and best practices in postoperative management, focusing on improving patient outcomes, enhancing recovery, and optimizing care following surgical procedures. The collection of articles within this Special Issue offers a comprehensive overview of strategies, interventions, and innovations in postoperative care, with the ultimate goal of promoting patient well-being and reducing complications.

Key Themes and Topics:

  1. Enhanced Recovery After Surgery (ERAS) Protocols:
  • Implementing evidence-based perioperative care pathways to promote faster recovery and minimize complications.
  • Multimodal pain management approaches and reducing opioid usage.
  • Early mobilization, nutrition, and hydration optimization for improved patient outcomes.
  1. Postoperative Pain Management:
  • Novel approaches to pain assessments and individualized pain management plans.
  • The role of regional anesthesia and opioid-sparing techniques in postoperative pain control.
  1. Early Detection and Management of Complications:
  • Strategies for the early identification and management of common postoperative complications, such as surgical site infections, deep vein thrombosis, and respiratory complications.
  • Remote monitoring and telemedicine applications for postoperative follow-up and timely interventions.
  • Novel diagnostic tools and biomarkers for the early detection of complications.
  1. Rehabilitation and Functional Recovery:
  • Comprehensive rehabilitation programs to optimize physical and functional recovery after surgery.
  • Progressive exercise regimes, physical therapy, and occupational therapy interventions.
  • Assistive technologies and devices to improve mobility and independence.

This Special Issue highlights the importance of postoperative management in ensuring successful outcomes and patient satisfaction. By exploring innovative approaches, evidence-based protocols, and advancements in various aspects of postoperative care, this collection of articles offers valuable insights for healthcare professionals into optimizing patient recovery, reducing complications, and enhancing the overall quality of care. The knowledge gained from this Special Issue can pave the way for further advancements in postoperative management and contribute to improved patient experiences and outcomes.

Dr. Antonino Zanghi
Dr. Luigi La Via
Dr. Antonino Maniaci
Dr. Alessandro Cappellani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • surgery
  • ERAS
  • postoperative management
  • recovery
  • pain

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (9 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

11 pages, 1072 KB  
Article
The Influence of Demographic Characteristics, Pre-Existing Conditions and Laboratory Parameters on Postoperative Hemorrhage After Brain Tumor Surgery
by Anatoli Pinchuk, Nikolay Tonchev, Anna Schaufler, Claudia A. Dumitru, Klaus-Peter Stein, Belal Neyazi, I. Erol Sandalcioglu and Ali Rashidi
Life 2025, 15(12), 1941; https://doi.org/10.3390/life15121941 - 18 Dec 2025
Viewed by 142
Abstract
Background: Postoperative hemorrhage (POH) is a rare yet serious complication of cranial surgery, potentially resulting in extended hospitalization, neurological impairment, or death. Existing predictive models often encompass diverse cranial pathologies, despite differing mechanisms of POH depending on the underlying condition. There is a [...] Read more.
Background: Postoperative hemorrhage (POH) is a rare yet serious complication of cranial surgery, potentially resulting in extended hospitalization, neurological impairment, or death. Existing predictive models often encompass diverse cranial pathologies, despite differing mechanisms of POH depending on the underlying condition. There is a lack of large-scale investigations focusing exclusively on POH following surgery for intracranial tumors. This study aimed to assess demographic variables—age, sex, and blood type—and pre-existing medical conditions as potential risk factors for POH in this specific context. Methods: A retrospective review was conducted on medical records of 1862 adult patients who underwent primary surgical resection of intracranial tumors. Univariate and multivariate analyses were applied to identify associations between POH and demographic or clinical characteristics. Results: POH, defined as postoperative hematoma necessitating surgical evacuation, was observed in 31 patients (1.7%). Univariate analysis revealed no statistically significant correlation between POH and demographic factors (age, sex) or pre-existing conditions such as hypertension, diabetes mellitus, cardiac disease, or liver dysfunction. Conclusions: The study found no evidence that demographic variables or pre-existing medical conditions independently contribute to the risk of POH following intracranial tumor resection in adults. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

23 pages, 6291 KB  
Article
A Novel Approach to Assessing In-Hospital Mortality After On-Pump Aortic Valve Replacement
by Anca Drăgan, Adrian Ştefan Drăgan and Ovidiu Ştiru
Life 2025, 15(11), 1696; https://doi.org/10.3390/life15111696 - 31 Oct 2025
Viewed by 458
Abstract
Background: Surgical aortic valve replacement (SAVR) is the main treatment for severe aortic valve disease, the most common valvular heart disease worldwide. Methods: We evaluated the in-hospital mortality risk factors and predictors following on-pump SAVR. We retrospectively reviewed data from consecutive patients treated [...] Read more.
Background: Surgical aortic valve replacement (SAVR) is the main treatment for severe aortic valve disease, the most common valvular heart disease worldwide. Methods: We evaluated the in-hospital mortality risk factors and predictors following on-pump SAVR. We retrospectively reviewed data from consecutive patients treated at a tertiary center from 2022 to 2024, focusing on routine hematological data and inflammatory indexes, alongside established factors. Results: Postoperative vasoactive-inotropic score (VIS) (OR 1.058, CI 95%: 1.007–1.112), platelet count (OR 1.033, CI 95%: 1.002–1.064), lymphocyte counts (OR 3.532, CI 95%: 1.507–8.278), and perioperative fresh frozen plasma transfusion (OR 1.335, CI 95%: 1.068–1.669) were independent risk factors for SAVR in-hospital mortality. VIS best predicted the endpoint (AUC 0.929, p = 0.001). Postoperative platelet count and platelet-to-lymphocytes ratio (PLR) outperformed the additive EuroSCORE in predicting the outcome, but not EuroSCORE II. Conclusions: Although EuroSCORE II remained superior to inflammatory indexes in predicting in-hospital death, the dynamic postoperative monitoring provided added value beyond static preoperative risk scores. This dynamic approach supported personalized monitoring and targeted therapeutic interventions. Postoperative VIS, platelet, lymphocyte counts, and PLR represent dynamic, low-cost predictors of in-hospital mortality after on-pump SAVR, offering a complementary value to EuroSCORE II–based models. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

14 pages, 1105 KB  
Article
Effect of Carboxymethylcellulose Hyaluronan (SEPRAFİLM®) on an Arthrofibrosis Model Created in Rabbit Knees
by Ismail Tugay Yagci, Ovunc Akdemir, Atilla Eyuboglu, Murat Sezak and Semih Aydogdu
Life 2025, 15(9), 1405; https://doi.org/10.3390/life15091405 - 5 Sep 2025
Viewed by 656
Abstract
Purpose: This study aimed to evaluate the efficacy of carboxymethylcellulose (Seprafilm®) for the prevention and treatment of arthrofibrosis in rabbit knees, as well as to investigate its underlying mechanisms of action against fibrosis and adhesion formation. Methods: Sixteen male New Zealand [...] Read more.
Purpose: This study aimed to evaluate the efficacy of carboxymethylcellulose (Seprafilm®) for the prevention and treatment of arthrofibrosis in rabbit knees, as well as to investigate its underlying mechanisms of action against fibrosis and adhesion formation. Methods: Sixteen male New Zealand white rabbits were randomly divided into two groups: a control group and a treatment group that received Seprafilm® following surgically induced arthrofibrosis in the knee joint. Macroscopic and histological assessments were performed to evaluate adhesion, fibrosis, inflammation, and edema. Results: In the control group, macroscopic adhesion was severe in five rabbits (62.5%), moderate in two (25%), and minimal in one (12.5%). No macroscopic adhesion was observed in the Seprafilm® group. The mean adhesion score was 2.5 ± 0.75 in the control group versus 0 in the treatment group (p < 0.001). Histologically, five rabbits (62.5%) in the control group showed significant fibrosis, and three (37.5%) showed moderate fibrosis, whereas all rabbits in the Seprafilm® group exhibited only minimal fibrosis (p < 0.001). Conclusions: Seprafilm® was effective in reducing both macroscopic and histological signs of adhesion and fibrosis in a rabbit arthrofibrosis model. These findings suggest its potential as a preventive and therapeutic agent in managing arthrofibrosis. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

12 pages, 893 KB  
Article
Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients
by Yuh-Chyn Tsai, Shih-Feng Liu, Hui-Chuan Chang, Ching-Min Huang, Wan-Chun Hsieh, Chin-Ling Li, Ting-Lung Lin and Ho-Chang Kuo
Life 2025, 15(2), 312; https://doi.org/10.3390/life15020312 - 17 Feb 2025
Viewed by 2184
Abstract
The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective [...] Read more.
The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective analysis of patients in a surgical intensive care unit, categorized into three major postoperative groups: cardiothoracic surgery, upper abdominal surgery, and other surgeries. Our analysis examined pre-extubation weaning profiles, vital signs before and after HFNC initiation, and changes in physiological parameters during HFNC use. A total of 90 patients were included, divided into two groups based on HFNC weaning success or failure. Key parameters analyzed included maximal inspiratory pressure (MIP), PaO2/FiO2 (P/F) ratio, vital signs, SpO2 levels, respiratory rate (RR), heart rate (HR), respiratory rate–oxygenation (ROX) index, and HFNC duration. The findings revealed that cardiothoracic and upper abdominal groups showed significantly higher HFNC weaning success rates (73.3% and 70.6%) compared to the other surgeries group (34.6%) (p = 0.004). Critical predictors of successful weaning included pre-HFNC SpO2, P/F ratio, and changes in the ROX index, particularly in upper abdominal and other surgeries groups. In cardiothoracic surgery patients, higher maximal inspiratory pressure (MIP) (p = 0.031) was associated with improved outcomes, while prolonged HFNC use correlated with weaning success in this group (p = 0.047). These findings underscore the necessity of tailoring HFNC strategies to surgical characteristics and individual patient profiles. For cardiothoracic surgery patients, pre-extubation MIP, post-extubation RR, ΔROX, and ΔHR were identified as key predictive factors. In upper abdominal surgery, pre-extubation P/F ratio, post-extubation SpO2, and ΔROX played crucial roles. For patients undergoing other types of surgeries, pre-extubation P/F ratio and ΔROX remained the most reliable predictors of HFNC weaning success. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

9 pages, 361 KB  
Article
Lower Levels of Vitamin D Are Associated with Higher Vasoactive–Inotropic Scores in Major Cardiac Surgery
by Adrian Stef, Constantin Bodolea, Simona Sorana Cainap, Monica Muntean, Aurelia Georgeta Solomonean, Nadina Tintiuc, Razvan Olimpiu Mada and Gabriel Cismaru
Life 2024, 14(11), 1349; https://doi.org/10.3390/life14111349 - 22 Oct 2024
Viewed by 1570
Abstract
Background: The vasoactive–inotropic score (VIS) predicts unfavorable outcomes after cardiac surgery in both children and adults. In our adult population, we investigated whether preoperative levels of vitamin D can predict the VIS and whether both vitamin D and the VIS can predict adverse [...] Read more.
Background: The vasoactive–inotropic score (VIS) predicts unfavorable outcomes after cardiac surgery in both children and adults. In our adult population, we investigated whether preoperative levels of vitamin D can predict the VIS and whether both vitamin D and the VIS can predict adverse outcomes following major heart surgery. Methods: Between 1 October 2021 and 28 February 2022, 300 patients underwent major cardiac surgery at our institution. Eighty-three of them had their 25-OH vitamin D levels measured before surgery. For this cohort, we calculated the VIS based on doses of vasoactive and inotropic medications administered post-surgery. Utilizing receiver operating curves, the predictive accuracy of vitamin D levels and the VIS in predicting acute kidney injury was assessed. Results: The median age of the cohort was 66 (IQR 61–71) years, with 59% being male and a median BMI of 28.4 (IQR 25.2–31.6). The most common procedures were aortic valve replacement, mitral valve replacement, coronary artery bypass grafting, aortic valve and ascending aorta repair, and ASD correction. There was a significant difference in the postoperative VIS between patients with vitamin D deficiency, i.e., <20 ng/mL, and patients with vitamin D values > 20 ng/mL (3.5 vs. 1.3 p < 0.04). We also found a significant correlation between the VIS and the days of hospitalization (r = 0.335; p = 0.002), the days of stay in the intensive care unit (r = 0.547; p < 0.00001), and the mechanical ventilation time (r = 0.327; p = 0.025). Both vitamin D levels and the VIS predicted postoperative acute kidney injury (p < 0.05). Conclusions: Vitamin D deficiency is correlated with the VIS in adults undergoing major cardiac surgery. Both vitamin D levels and the VIS can predict unfavorable postoperative outcomes. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

17 pages, 622 KB  
Review
Impact of General Anesthetics on Postoperative Infections—A Narrative Review
by Taylor P. L. Butt, Lynn Jazzar, Palak Watts and Christian Lehmann
Life 2025, 15(11), 1662; https://doi.org/10.3390/life15111662 - 23 Oct 2025
Viewed by 1308
Abstract
Postoperative infections represent the most frequent complication after surgery. Anesthetic agents, while essential during surgical procedures to ensure unconsciousness, are becoming increasingly recognized as modulators of immune function. Volatile anesthetics have been identified as being able to attenuate the inflammatory response in diverse [...] Read more.
Postoperative infections represent the most frequent complication after surgery. Anesthetic agents, while essential during surgical procedures to ensure unconsciousness, are becoming increasingly recognized as modulators of immune function. Volatile anesthetics have been identified as being able to attenuate the inflammatory response in diverse experimental models. Propofol, a widely used intravenous anesthetic, has also been described to exhibit strong anti-inflammatory mechanisms. This review synthesizes current cellular, experimental, and clinical evidence on the immunomodulatory effects of anesthetic agents, highlighting their impact on host defense mechanisms and postoperative infections. By exploring mechanistic properties and clinical outcomes, it underscores the importance of anesthetic choice in enhancing immune function and postoperative recovery. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

27 pages, 681 KB  
Review
Safety in Spine Surgery: Risk Factors for Intraoperative Blood Loss and Management Strategies
by Magdalena Rybaczek, Piotr Kowalski, Zenon Mariak, Michał Grabala, Joanna Suszczyńska, Tomasz Łysoń and Paweł Grabala
Life 2025, 15(10), 1615; https://doi.org/10.3390/life15101615 - 16 Oct 2025
Cited by 2 | Viewed by 1956
Abstract
Background: Massive intraoperative blood loss (IBL) is a serious complication in complex spine surgeries such as deformity correction, multilevel fusion, tumor resection, and revision procedures. While no strict definition exists, blood loss exceeding 1500 mL or 20% of estimated blood volume is generally [...] Read more.
Background: Massive intraoperative blood loss (IBL) is a serious complication in complex spine surgeries such as deformity correction, multilevel fusion, tumor resection, and revision procedures. While no strict definition exists, blood loss exceeding 1500 mL or 20% of estimated blood volume is generally considered clinically significant. Excessive bleeding increases the risk of hemodynamic instability, transfusion-related complications, postoperative infection, and prolonged hospitalization. Methods: This narrative review summarizes the current understanding of the incidence, risk factors, anatomical vulnerabilities, and evidence-based strategies for managing IBL in spine surgery through comprehensive literature analysis of recent studies and clinical guidelines. Results: Key risk factors include patient characteristics (anemia, obesity, advanced age, medication use), surgical variables (multilevel instrumentation, revision status, operative time), and pathological conditions (hypervascular tumors, severe deformity). Perioperative medication management is critical, requiring discontinuation of NSAIDs (5–7 days), antiplatelet agents (5–7 days), and NOACs (48–72 h) preoperatively to minimize bleeding risk. The thoracolumbar junction and hypervascular spinal lesions are especially prone to bleeding due to dense vascular anatomy. Evidence-based management strategies include comprehensive preoperative optimization, intraoperative hemostatic techniques, antifibrinolytic agents, topical hemostatic products, cell salvage technology, and structured transfusion protocols. Conclusions: Effective management of massive IBL requires a multimodal approach combining preoperative risk assessment and medication optimization, intraoperative hemostatic strategies including tranexamic acid administration, advanced monitoring techniques, and coordinated transfusion protocols. Particular attention to perioperative management of anticoagulant and antiplatelet medications is essential for bleeding risk mitigation. Understanding patient-specific risk factors, surgical complexity, and anatomical considerations enables surgeons to implement targeted prevention and management strategies, ultimately improving patient outcomes and reducing complications in high-risk spine surgery procedures. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

20 pages, 1303 KB  
Review
Neurological and Olfactory Disturbances After General Anesthesia
by Antonino Maniaci, Mario Lentini, Rosario Trombadore, Loris Gruppuso, Santo Milardi, Rosario Scrofani, Giuseppe Cuttone, Massimiliano Sorbello, Rodolfo Modica, Jerome R. Lechien, Paolo Boscolo-Rizzo, Daniele Salvatore Paternò and Luigi La Via
Life 2025, 15(3), 344; https://doi.org/10.3390/life15030344 - 22 Feb 2025
Cited by 2 | Viewed by 3037
Abstract
Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential [...] Read more.
Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential long-term effects. These disturbances, including postoperative cognitive dysfunction, delirium, and olfactory deficits, often arise from shared pathophysiological mechanisms, such as neuroinflammation, oxidative stress, and disruptions in cerebral perfusion. The olfactory system is particularly susceptible to anesthesia-induced neurotoxicity given its proximity to central nervous system structures and its role in sensory and cognitive processing. Furthermore, the unique regenerative capacity of olfactory neurons may be compromised by prolonged or repeated exposure to anesthetic agents, potentially leading to long-term olfactory dysfunction. Risk factors, such as advanced age, neurodegenerative diseases, diabetes, cardiovascular conditions, genetic predispositions, and the type and duration of anesthesia exposure, further exacerbate these complications. Preventive strategies, including comprehensive preoperative risk assessment, personalized anesthetic protocols based on genetic and physiological profiles, and proactive postoperative care with early intervention programs, are critical for reducing impairments and improving long-term patient outcomes. Emerging evidence highlights the potential role of neuroprotective agents, such as antioxidants and anti-inflammatory therapies, in mitigating the effects of anesthesia-induced neurotoxicity. Longitudinal studies are needed to evaluate the long-term effects of anesthesia on cognitive and sensory health, particularly in high-risk populations. These studies should incorporate advanced neuroimaging techniques and biomarker analysis to elucidate the underlying mechanisms of anesthesia-induced neurological and olfactory disturbances. This narrative review provides a comprehensive overview of the mechanisms, risk factors, and preventive strategies for neurological and olfactory disturbances after general anesthesia and highlights future directions for research to improve patient outcomes. We conducted a comprehensive literature search using databases, such as PubMed and Scopus, to identify relevant studies. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

23 pages, 1104 KB  
Systematic Review
Management of Iatrogenic Bile-Duct Injury After Cholecystectomy, 1995–2025: Systematic Review and Meta-Analysis
by Catalin Piriianu, Elena-Adelina Toma, Octavian Enciu, Mugur Ardelean, Adrian Miron and Valentin Calu
Life 2025, 15(12), 1858; https://doi.org/10.3390/life15121858 - 3 Dec 2025
Viewed by 575
Abstract
Iatrogenic bile duct injury (IBDI) constitutes a major complication of cholecystectomy. The optimal timing, method, and setting for definitive repair remain subjects of debate. This study aimed to systematically evaluate management strategies, timing of repair, and prognostic factors influencing postoperative outcomes following IBDI. [...] Read more.
Iatrogenic bile duct injury (IBDI) constitutes a major complication of cholecystectomy. The optimal timing, method, and setting for definitive repair remain subjects of debate. This study aimed to systematically evaluate management strategies, timing of repair, and prognostic factors influencing postoperative outcomes following IBDI. A systematic review and meta-analysis were conducted in accordance with PRISMA and MOOSE guidelines (PROSPERO CRD420251003227). PubMed and the Cochrane Library were searched through March 2025. Eligible randomized trials and cohort studies reporting management outcomes were included. Data extraction and quality assessment were performed independently. Pooled analyses were conducted using random-effects models. Twenty-eight studies (2 randomized trials, 24 cohort studies, 2 systematic reviews) involving >18,000 patients were analyzed. Surgical repair achieved higher success than endoscopic therapy (92.6% vs. 76.1%; RR 1.22, 95% CI 1.10–1.35) and reduced stricture risk (RR 0.24, 95% CI 0.15–0.38). Roux-en-Y hepaticojejunostomy provided durable outcomes (success 83.5%; stricture 8.9%). Early (<2 weeks) or delayed (>6 weeks) repair after sepsis control was associated with lower morbidity (9–11%) compared with intermediate repair (2–6 weeks). Referral to hepatopancreatobiliary (HPB) centers reduced complications (RR 0.32, 95% CI 0.23–0.46). Overall morbidity and mortality were 22.7% and 2.9%. Outcomes following IBDI are determined primarily by surgical expertise and patient stability rather than timing alone. In optimized patients, both early and delayed reconstruction are safe and effective, whereas intermediate repair and non-specialist interventions increase risk. Timely referral to HPB centers should be considered standard practice. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-9
Back to TopTop