Machine Learning-Based Analysis in the Management of Iatrogenic Bile Duct Injury During Cholecystectomy : a Nationwide Multicenter Study
Lopez-Lopez, Victor (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Maupoey, Javier (Hospital Universitari i Politècnic La Fe (València))
López-Andujar, Rafael (Hospital Universitari i Politècnic La Fe (València))
Ramos, Emilio (Hospital Universitari de Bellvitge)
Mils, Kristel (Hospital Universitari de Bellvitge)
Martinez, Pedro Antonio (Universidad de Murcia)
Valdivieso, Andres (Hospital Universitari de Cruces)
Garcés-Albir, Marina (Universitat de València)
Sabater, Luis (Universitat de València)
Valladares, Luis Díez (Hospital Clínico San Carlos (Madrid))
Pérez, Sergio Annese (Hospital Universitario de Morales)
Flores, Benito (Hospital Universitario de Morales)
Brusadin, Roberto (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Conesa, Asunción López (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Cayuela, Valentin (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Cortijo, Sagrario Martinez (Hospital Universitario de Alcorcon)
Paterna, Sandra (Hospital Universitario Miguel Servet (Saragossa))
Serrablo, Alejando (Hospital Universitario Miguel Servet (Saragossa))
Sánchez-Cabús, Santiago (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Gil, Antonio González (Hospital Universitario Los Arcos del Mar Menor)
Masía, Jose Antonio González (Hospital Universitario General)
Loinaz, Carmelo (Hospital Universitario 12 de Octubre (Madrid))
Lucena, Jose Luis (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Pastor, Patricia (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Garcia-Zamora, Cristina (Hospital Rafael Mendez)
Calero, Alicia (Hospital Universitario Elche)
Valiente, Juan (Hospital Hellin)
Minguillon, Antonio (Hospital Obispo Polanco)
Rotellar, Fernando
Ramia, Jose Manuel (Hospital Universitario Dr. Balmis General)
Alcazar, Cándido (Hospital Universitario Dr. Balmis General)
Aguilo, Javier (Hospital Lluís Alcanyís)
Cutillas, Jose (Hospital Francesc de Borja)
Kuemmerli, Christoph
Ruiperez-Valiente, Jose A. (Universidad de Murcia)
Robles-Campos, Ricardo (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Iatrogenic bile duct injury (IBDI) is a challenging surgical complication. IBDI management can be guided by artificial intelligence models. Our study identified the factors associated with successful initial repair of IBDI and predicted the success of definitive repair based on patient risk levels. This is a retrospective multi-institution cohort of patients with IBDI after cholecystectomy conducted between 1990 and 2020. We implemented a decision tree analysis to determine the factors that contribute to successful initial repair and developed a risk-scoring model based on the Comprehensive Complication Index. We analyzed 748 patients across 22 hospitals. Our decision tree model was 82. 8% accurate in predicting the success of the initial repair. Non-type E (p < 0. 01), treatment in specialized centers (p < 0. 01), and surgical repair (p < 0. 001) were associated with better prognosis. The risk-scoring model was 82. 3% (79. 0-85. 3%, 95% confidence interval [CI]) and 71. 7% (63. 8-78. 7%, 95% CI) accurate in predicting success in the development and validation cohorts, respectively. Surgical repair, successful initial repair, and repair between 2 and 6 weeks were associated with better outcomes. Machine learning algorithms for IBDI are a novel tool may help to improve the decision-making process and guide management of these patients. The online version contains supplementary material available at 10. 1007/s11605-022-05398-7.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Iatrogenic bile duct injury ; Cholecystectomy ; Machine learning ; Artificial neural network
Publicado en:	Journal of Gastrointestinal Surgery, Vol. 26 (july 2022) , p. 1713-1723, ISSN 1873-4626

DOI: 10.1007/s11605-022-05398-7
PMID: 35790677

11 p, 1.1 MB

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