What question did this study set out to answer?

Assess the etiology, outcomes, and predictors of postoperative complications in patients treated for extrahepatic biliary obstruction.

July 2, 2026Open Access

Etiologies, outcomes, and predictors of postoperative complications in the surgical management of extrahepatic biliary obstruction: a study at Tikur Anbesa specialized hospital, Ethiopia

Key Points

Assess the etiology, outcomes, and predictors of postoperative complications in patients treated for extrahepatic biliary obstruction.
Conducted a retrospective cohort study with 122 patients undergoing surgical intervention for EHBO.
Performed univariate and multivariate binary logistic regression analyses to identify predictors of complications.
Measured normality of data using Shapiro-Wilk test and reported summary statistics accordingly.
The 30-day postoperative complication rate was 25.4% with surgical site infection being the most common (19.7%).
Independent predictors included ECOG status (AOR 6.1, 95% CI 2.0-18.4; p=0.001) and jaundice duration > 8 weeks (AOR 2.1, 95% CI 1.7-6.3; p=0.003).
Curative resection was achieved in 32.8% of patients, with a postoperative mortality rate of 1.6%.

Abstract

BACKGROUND: Obstructive jaundice has contributed a sizable burden of global mortality, morbidity, economic cost, and hospitalization worldwide cause by benign and malignant conditions. OBJECTIVE: To assess the etiological pattern, predictors for postoperative complications, and short-term outcomes among patients undergoing surgical intervention for EHBO at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2024. METHODS: A hospital-based retrospective cohort study was conducted to evaluate the etiological patterns, outcomes, and predictors of complications following surgical intervention for extrahepatic biliary obstruction (EHBO). The study included 122 EHBO patients who were consecutively enrolled during the study period. Normality of continuous variables was assessed using the Shapiro-Wilk test; normally distributed data were expressed as means with standard deviations, whereas skewed variables were reported as medians with interquartile ranges. Univariate and multivariate binary logistic regression analyses were performed to identify predictors of 30-day postoperative complications. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI), and a p-value 8 weeks (AOR 2.1, 95% CI 1.7-6.3; p = 0.003) as independent predictors of postoperative complications. CONCLUSION: Our findings demonstrate that favorable surgical outcomes for EHBO are achievable even in resource-constrained environments. However, further mitigating postoperative morbidity requires targeted perioperative optimization of high-risk patients, specifically those presenting with prolonged jaundice (> 8 weeks), preoperative cholangitis, poor ECOG performance status, hypoalbuminemia, and malignant biliary obstruction (MBO). Consequently, implementing systematic risk stratification and addressing these key clinical predictors are imperative to minimize complications and optimize patient outcomes. TRIAL REGISTRATION: Not applicable.

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