Back to Program | 2010 Program and Abstracts Overview | 2010 Posters

Objective The aim of this study was to assess complications and functional outcomes in patients having ileal pouch-anal anastomosis for ulcerative colitis with or without primary sclerosing cholangitis or other extra intestinal manifestations; in particular if primary sclerosing cholangitis is a risk factor for pouchitisMaterial and methods During the period 1984 - 2007 289 patients with ulcerative colitis underwent proctocolectomy and construction of ileal pouch-anal anastomosis. All patients were followed up at our outpatient clinic and data recorded prospectively. Mean follow-up was 12 years. Eleven patients had primary sclerosing cholangitis, nine had pyoderma gangrenosum, and twelve had arthitis or ankylosing spondylitis.Results Early complications like postoperatively bleedings, anastomotic leakages, pelvic sepsis and fistulas were similar for patients with or without extra intestinal manifestations. Patients with primary sclerosing cholangitis had more episodes of pouchitis, 5.25 vs. 2.72 (p = 0.048), and more chronic pouchitis, 4/11 vs. 17/260 (p < 0.001) compared to patients without adjunct disease. They also had more day time incontinence, 0.55 vs. 0.07 (p = 0.007) episodes per week, respectively. The frequency of bowel movements was similar in all groups. Neoplasm of the colon was more frequent in patients having primary sclerosing cholangitis, 4/11 vs. 4/260 in ulcerative patients (p < 0.001). Patients with pyoderma gangrenosum or arthitis/ankylosing spondylitis had outcomes similar to patients without adjunct diseases.Conclusion An association between primary sclerosing cholangitis and chronic/severe pouchitis was found. There was no association between pouchitis and pyoderma gangrenosum or arthritis/ ankylosing spondylitis. Long term functional outcome or surgical complications did not differ between the groups. Primary sclerosing cholangitis is a risk factor for chronic pouchitis.