Machine Learning-Based Analysis in the Management of Iatrogenic Bile Duct Injury During Cholecystectomy

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....

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Detalles Bibliográficos
Autores: Lopez-Lopez, Victor|||0000-0003-1718-3352, Maupoey, Javier, López-Andujar, Rafael, Ramos, Emilio|||0000-0002-2688-0101, Mils, Kristel|||0000-0002-2543-4775, Martinez, Pedro Antonio, Valdivieso, Andres, Garcés-Albir, Marina|||0000-0001-9474-6521, Sabater, Luis|||0000-0002-7510-8118, Valladares, Luis Díez, Pérez, Sergio Annese, Flores, Benito, Brusadin, Roberto, Conesa, Asunción López, Cayuela, Valentin, Cortijo, Sagrario Martinez, Paterna, Sandra, Serrablo, Alejando, Sánchez-Cabús, Santiago|||0000-0002-0575-1466, Gil, Antonio González, Masía, Jose Antonio González, Loinaz, Carmelo|||0000-0002-1873-0568, Lucena, Jose Luis, Pastor, Patricia, Garcia-Zamora, Cristina, Calero, Alicia, Valiente, Juan, Minguillon, Antonio, Rotellar-Sastre, Fernando|||0000-0002-6557-0712, Ramia, José M.|||0000-0003-1186-953X, Alcazar, Cándido, Aguilo, Javier, Cutillas, Jose, Kuemmerli, Christoph, Ruiperez-Valiente, Jose A., Robles-Campos, Ricardo
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281818
Acceso en línea:https://ddd.uab.cat/record/281818
https://dx.doi.org/urn:doi:10.1007/s11605-022-05398-7
Access Level:acceso abierto
Palabra clave:Iatrogenic bile duct injury
Cholecystectomy
Machine learning
Artificial neural network
Descripción
Sumario: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.

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