Intestinal failure associated cholestasis in surgical necrotizing enterocolitis and spontaneous intestinal perforation
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Topic overview
Abstract
Background
Surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) is often complicated by intestinal failure (IF) and intestinal failure associated cholestasis (IFAC).
Objective
Assessment of incidence, predictors, and mortality associated with IFAC in surgically treated NEC and SIP.
Methods: A retrospective observational study based on hospital records during 1986–2014 in the two largest Finnish neonatal intensive care units was performed. IFAC was defined as conjugated bilirubin >34 μmol/l (2.0 mg/dl) for ≥ two postoperative weeks while receiving parenteral nutrition (PN).
Results
In total 225 patients underwent surgery for NEC (n = 142; 63%) or SIP (n = 83; 37%). Included were 57 survivors with ≥two weeks PN. Sixty-five (42%) patients developed IFAC. Two-year survival with IFAC was 80% and without IFAC 89% (p = 0.13). Of the 65 patients with IFAC, all eight with unresolved IFAC died in comparison to six of 57 (11%) whose IFAC resolved (p
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