{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:30:58Z","timestamp":1773037858510,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Major bile duct injury (BDI) is a severe complication of biliary surgery, associated with high morbidity, mortality, and long\u2010term sequelae. This study aimed to identify predictors of outcomes after surgical repair of major BDI in a North African hepatopancreatobiliary center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 147 patients who underwent repair of Strasberg type E BDI at a single HPB department in Oran, Algeria (2014\u20132024). Outcomes included morbidity, 90\u2010day mortality, and long\u2010term complications (Terblanche grade &gt;\u20091). Logistic regression identified independent predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 49.1\u2009years, 67.3% were female, and 62.6% sustained injury during laparoscopic cholecystectomy; vascular injury occurred in 17.7%. Hepaticojejunostomy was performed in 95.9%, mostly after delayed referral (&gt;\u20096\u2009weeks in 91.2%). Morbidity occurred in 35.4%, bile leakage in 16.3%, and 90\u2010day mortality in 4.1%. At a median follow\u2010up of 69\u2009months, 95.8% achieved Terblanche grade 1 outcomes. Independent predictors were laparoscopic index surgery for morbidity (OR\u2009=\u20095.41, 95% CI 1.08\u201327.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040); age (OR\u2009=\u20091.10, 95% CI 1.01\u20131.19;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028), vascular injury (OR\u2009=\u200916.45, 95% CI 2.13\u2013127.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and bilirubin \u2265\u200915\u2009mg\/dL (OR\u2009=\u200919.74, 95% CI 1.74\u2013224.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) for mortality. Immediate repair predicted unfavorable long\u2010term outcomes (OR\u2009=\u200910.44, 95% CI 1.60\u201368.34;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hepaticojejunostomy providing durable reconstruction. However, laparoscopic causative surgery, advanced age, vascular injury, and severe hyperbilirubinemia predicted adverse early outcomes, while immediate repair increased the risk of late stricture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70440","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T10:46:38Z","timestamp":1766141198000},"page":"240-250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Morbidity, Mortality, and Long\u2010Term Outcomes After Surgical Repair of Major Bile Duct Injuries: A 10\u2010Year Experience From a North African\n                    <scp>HPB<\/scp>\n                    Center"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3264-2441","authenticated-orcid":false,"given":"Anisse","family":"Tidjane","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery 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