{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:57:39Z","timestamp":1793465859449,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative cholangitis is a common complication of pancreaticoduodenectomy. Frequent cholangitis impairs patients\u2019 quality of life after pancreaticoduodenectomy. However, the risk factors for recurrence of cholangitis remain unclear. Hence, this retrospective study aimed to identify risk factors for recurrence of cholangitis after pancreaticoduodenectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of patients who underwent pancreaticoduodenectomy between 2015 and 2019\u00a0in our institution were retrospectively reviewed. At least two episodes of cholangitis a year after pancreaticoduodenectomy were defined as \u2018recurrence of cholangitis\u2019 in the present study. Univariate and multivariate analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The recurrence of cholangitis occurred in 40 of 207 patients (19.3%). Multivariate analysis revealed that internal stent (external, RR<jats:italic>:<\/jats:italic> 2.16, <jats:italic>P<\/jats:italic>\u2009=\u20090.026; none, RR<jats:italic>:<\/jats:italic> 4.76, <jats:italic>P<\/jats:italic>\u2009=\u20090.011), firm pancreas (RR<jats:italic>:<\/jats:italic> 2.61, <jats:italic>P<\/jats:italic>\u2009=\u20090.021), constipation (RR<jats:italic>:<\/jats:italic> 3.49, <jats:italic>P<\/jats:italic>\u2009=\u20090.008), and postoperative total bilirubin&gt;1.7\u00a0mg\/dL (RR<jats:italic>:<\/jats:italic> 2.94, <jats:italic>P<\/jats:italic>\u2009=\u20090.006) were risk factors of recurrence of cholangitis. Among patients with internal stents (<jats:italic>n<\/jats:italic>\u2009=\u200954), those with remnant stents beyond 5\u00a0months had more frequent recurrence of cholangitis (\u22655\u00a0months, 75%;\u2009&lt;5\u00a0months, 30%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Internal stents, firm pancreas, constipation, and postoperative high bilirubin levels are risk factors for cholangitis recurrence after pancreaticoduodenectomy. In addition, the long\u2010term implantation of internal stents may trigger cholangitis recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07104-3","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T18:02:10Z","timestamp":1689271330000},"page":"2499-2506","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk Factors for Recurrence of Cholangitis After Pancreaticoduodenectomy and Comparison of Stents in Hepaticojejunostomy"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8232-8418","authenticated-orcid":false,"given":"Hirotaka","family":"Fukuoka","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirochika","family":"Toyama","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Mizumoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ishida","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaki","family":"Asari","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahiro","family":"Goto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihide","family":"Nanno","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Urade","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Gon","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Tsugawa","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Kuramitsu","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Yanagimoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kido","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Ajiki","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Fukumoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine 7\u20105\u20102\u00a0Kusunoki\u2010cho, Chuo\u2010ku 650\u20100017 Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200012000\u201000007"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957\u2010017\u20101301\u20106"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.08.003"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477\u20102574.2011.00319.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.12.002"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.512"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00311679"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.12.026"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.584"},{"key":"e_1_2_7_12_1","first-page":"491","article-title":"Microflora of the gastrointestinal tract: a review","volume":"268","author":"Hao WL","year":"2004","journal-title":"Methods Mol Biol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.116.014407"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02093603"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20103912\u2010z"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1095"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07104-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-023-07104-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07104-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-023-07104-3","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T06:47:49Z","timestamp":1705214869000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-023-07104-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,13]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1007\/s00268-023-07104-3"],"URL":"https:\/\/doi.org\/10.1007\/s00268-023-07104-3","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,13]]},"assertion":[{"value":"2 June 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest associated with this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}