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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2023; 15(2): 234-248
Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.234
Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study
Tamer A A M Habeeb, Abdulzahra Hussain, Mauro Podda, Pasquale Cianci, Bruce Ramshaw, Khaled Safwat, Wesam M Amr, Tamer Wasefy, Alaa A Fiad, Mohamed Ibrahim Mansour, Adel Mahmoud Moursi, Gamal Osman, Anass Qasem, Mohamed Fawzy, Mohamed Ibrahim Abo Alsaad, Abd-Elfattah Kalmoush, Mohammed Shaaban Nassar, Fawzy M Mustafa, Mahmoud Hassib Morsi Badawy, Ahmed Hamdy, Hamdi Elbelkasi, Bassam Mousa, Abd-Elrahman M Metwalli, Walid A Mawla, Mostafa M Elaidy, Muhammad Ali Baghdadi, Ahmed Raafat
Tamer A A M Habeeb, Khaled Safwat, Wesam M Amr, Tamer Wasefy, Alaa A Fiad, Mohamed Ibrahim Mansour, Adel Mahmoud Moursi, Gamal Osman, Bassam Mousa, Abd-Elrahman M Metwalli, Walid A Mawla, Mostafa M Elaidy, Muhammad Ali Baghdadi, Ahmed Raafat, Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
Abdulzahra Hussain, Homerton University Hospital, London E9 6SR, UK
Mauro Podda, Department of Surgical Science, University of Cagliari, Cagliari 2432, Italy
Pasquale Cianci, Department of Medical and Surgical Sciences, Università degli studi di Foggia, Foggia 546, Italy
Bruce Ramshaw, MD CQInsights PBC, Co-founder & CEO, Tennessee, TN 37010, United States
Anass Qasem, Department of Internal Medicine, Zagazig University, Zagazig 2355, Egypt
Mohamed Fawzy, Department of Internal Medicine, Suez University, Suez 235, Egypt
Mohamed Ibrahim Abo Alsaad, Department of General Surgery, Faculty of Medicine -Merit University, Sohag 82511, Egypt
Abd-Elfattah Kalmoush, Mohammed Shaaban Nassar, Fawzy M Mustafa, Mahmoud Hassib Morsi Badawy, Department of General Surgery, Al-azhar University, Cairo 285, Egypt
Ahmed Hamdy, Department of Hepato-Bilio-Pancreatic (HBP) Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo 285, Egypt
Hamdi Elbelkasi, Department of General Surgery, Mataryia Teaching Hospital, Cairo 285, Egypt
Author contributions: Habeeb TAAM is the corresponding author and is responsible for patient recruitment; Habeeb TAAM, Hussain A, Podda M, Cianci P, Ramshaw B, Safwat K, Amr WM, Wasefy T, Fiad AA, Mansour MI, Moursi AM, Osman G, Qasem A, Fawzy M, Alsaad MIA, Kalmoush A, Nassar MS, Mustafa FM, Badawy MHM, Hamdy A, Elbelkasi H, Mousa B, Metwalli AM, Mawla WA, Elaidy MM, Baghdadi MA, Raafat A shared data collection, data analysis, study design, and writing up the first draft and final form of the manuscript; All authors accept the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Zagazig University Institutional Review Board (Approval No. ZU IRB#9841).
Informed consent statement: Informed written consent was obtained from the patient and her family for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be available by the author on demand.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tamer A A M Habeeb, MD, Professor, Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt. tameralnaimy@hotmail.com
Received: October 7, 2022
Peer-review started: October 7, 2022
First decision: January 3, 2023
Revised: January 5, 2023
Accepted: February 3, 2023
Article in press: February 3, 2023
Published online: February 27, 2023
ARTICLE HIGHLIGHTS
Research background
Inflammatory bowel disease (IBD) is expected to affect 1% of the population over the next decade. Hepatobiliary manifestations constitute one of the most common extraintestinal manifestations in IBD. Primary sclerosing cholangitis (PSC), autoimmune hepatitis, fatty liver, cholelithiasis, primary biliary cholangitis, portal vein thrombosis, and hepatic abscess are the most prevalent hepatobiliary manifestations of ulcerative colitis (UC). Most UC patients can be managed with medications, but minorities require proctocolectomy.
Research motivation
Two-stage laparoscopic proctocolectomy (LRP) with ileal pouch-anal anastomosis (IPAA) is a cure for UC, but its effect on hepatobiliary diseases is controversial.
Research objectives
Therefore, we conducted a prospective observational study to examine the effects of LRP with IPAA on hepatobiliary symptoms to evaluate the role of surgery in preventing or ameliorating liver damage from the disease progression.
Research methods
This is a prospective observational study on 167 patients with hepatobiliary manifestations who underwent two-stage elective LRP with IPAA for UC We examined the effects of LRP with IPAA on hepatobiliary symptoms to evaluate the role of surgery in preventing or ameliorating liver damage from the disease progression.
Research results
The course of hepatobiliary manifestations after surgery is improved in most forms. Most PSC patients had a stable course, Two-thirds of fatty liver patients showed a regressive course with an improved survival rate at the end of the study.
Research conclusions
Our study emphasized the positive and improving effects of surgery on hepatobiliary manifestations in patients with UC.
Research perspectives
Further studies are required in a larger sample size to evaluate the effect of surgery on different forms of hepatobiliary manifestations in patients with UC. further studies are required to compare the effect of surgery and effects of medical treatment.
