Radiation therapy increases the risk of hepatobiliary complications in short bowel syndrome

Jon S Thompson, Rebecca Weseman, Fedja A Rochling, Wendy Grant, Jean Botha, Alan Norman Langnas, David F Mercer

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Patients developing short bowel syndrome (SBS) are at risk for hepatobiliary complications. Radiation enteritis and radiation-induced liver disease are potential complications of radiation therapy (XRT). The authors hypothesized that SBS patients with a history of abdominal XRT would be at increased risk for hepatobiliary complications. Methods: The authors reviewed 92 adult patients developing SBS as a complication of operation for malignancy (n = 37) and/or XRT (n = 55). Hepatobiliary disease was evaluated by liver function tests, radiologic imaging, endoscopy, and histologic studies. Results: Rectal cancer was the most frequent tumor in both groups (36% vs 35%). There were significantly more ovarian cancers (18% vs 3%, P <.05) in the radiation group and fewer desmoid tumors (0% vs 24%, P <.05). Intestinal remnant length was similar, but radiation patients more frequently had colon present (87% vs 62%, P <.05) and were less likely to have type I anatomy (33% vs 65%, P <.05). Radiation patients were less likely to be weaned off parenteral nutrition (PN; 16% vs 41%, P <.05). Cirrhosis/portal hypertension was more frequent in the radiation group (35% vs 11%, P <.05). Radiographic evidence of fatty liver, end-stage liver disease and the risk of cholelithiasis post-SBS were similar in both groups. Conclusions: SBS patients with a history of XRT were more likely to develop cirrhosis and portal hypertension than SBS patients with malignancy alone. Radiation SBS patients were less likely to wean from PN despite more favorable intestinal anatomy.

Original languageEnglish (US)
Pages (from-to)474-478
Number of pages5
JournalNutrition in Clinical Practice
Volume26
Issue number4
DOIs
StatePublished - Aug 1 2011

Fingerprint

Short Bowel Syndrome
Radiotherapy
Radiation
Portal Hypertension
Neoplasms
Anatomy
Fibrosis
Aggressive Fibromatosis
End Stage Liver Disease
Cholelithiasis
Enteritis
Liver Function Tests
Parenteral Nutrition
Fatty Liver
Rectal Neoplasms
Ovarian Neoplasms
Endoscopy
Liver Diseases
Colon

Keywords

  • biliary tract diseases
  • liver cirrhosis
  • liver diseases
  • radiotherapy
  • short bowel syndrome

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Radiation therapy increases the risk of hepatobiliary complications in short bowel syndrome. / Thompson, Jon S; Weseman, Rebecca; Rochling, Fedja A; Grant, Wendy; Botha, Jean; Langnas, Alan Norman; Mercer, David F.

In: Nutrition in Clinical Practice, Vol. 26, No. 4, 01.08.2011, p. 474-478.

Research output: Contribution to journalReview article

@article{7dca4610bb974db2bc3d08406e2cfcd1,
title = "Radiation therapy increases the risk of hepatobiliary complications in short bowel syndrome",
abstract = "Patients developing short bowel syndrome (SBS) are at risk for hepatobiliary complications. Radiation enteritis and radiation-induced liver disease are potential complications of radiation therapy (XRT). The authors hypothesized that SBS patients with a history of abdominal XRT would be at increased risk for hepatobiliary complications. Methods: The authors reviewed 92 adult patients developing SBS as a complication of operation for malignancy (n = 37) and/or XRT (n = 55). Hepatobiliary disease was evaluated by liver function tests, radiologic imaging, endoscopy, and histologic studies. Results: Rectal cancer was the most frequent tumor in both groups (36{\%} vs 35{\%}). There were significantly more ovarian cancers (18{\%} vs 3{\%}, P <.05) in the radiation group and fewer desmoid tumors (0{\%} vs 24{\%}, P <.05). Intestinal remnant length was similar, but radiation patients more frequently had colon present (87{\%} vs 62{\%}, P <.05) and were less likely to have type I anatomy (33{\%} vs 65{\%}, P <.05). Radiation patients were less likely to be weaned off parenteral nutrition (PN; 16{\%} vs 41{\%}, P <.05). Cirrhosis/portal hypertension was more frequent in the radiation group (35{\%} vs 11{\%}, P <.05). Radiographic evidence of fatty liver, end-stage liver disease and the risk of cholelithiasis post-SBS were similar in both groups. Conclusions: SBS patients with a history of XRT were more likely to develop cirrhosis and portal hypertension than SBS patients with malignancy alone. Radiation SBS patients were less likely to wean from PN despite more favorable intestinal anatomy.",
keywords = "biliary tract diseases, liver cirrhosis, liver diseases, radiotherapy, short bowel syndrome",
author = "Thompson, {Jon S} and Rebecca Weseman and Rochling, {Fedja A} and Wendy Grant and Jean Botha and Langnas, {Alan Norman} and Mercer, {David F}",
year = "2011",
month = "8",
day = "1",
doi = "10.1177/0884533611414028",
language = "English (US)",
volume = "26",
pages = "474--478",
journal = "Nutrition in Clinical Practice",
issn = "0884-5336",
publisher = "SAGE Publications Ltd",
number = "4",

}

TY - JOUR

T1 - Radiation therapy increases the risk of hepatobiliary complications in short bowel syndrome

AU - Thompson, Jon S

AU - Weseman, Rebecca

AU - Rochling, Fedja A

AU - Grant, Wendy

AU - Botha, Jean

AU - Langnas, Alan Norman

AU - Mercer, David F

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Patients developing short bowel syndrome (SBS) are at risk for hepatobiliary complications. Radiation enteritis and radiation-induced liver disease are potential complications of radiation therapy (XRT). The authors hypothesized that SBS patients with a history of abdominal XRT would be at increased risk for hepatobiliary complications. Methods: The authors reviewed 92 adult patients developing SBS as a complication of operation for malignancy (n = 37) and/or XRT (n = 55). Hepatobiliary disease was evaluated by liver function tests, radiologic imaging, endoscopy, and histologic studies. Results: Rectal cancer was the most frequent tumor in both groups (36% vs 35%). There were significantly more ovarian cancers (18% vs 3%, P <.05) in the radiation group and fewer desmoid tumors (0% vs 24%, P <.05). Intestinal remnant length was similar, but radiation patients more frequently had colon present (87% vs 62%, P <.05) and were less likely to have type I anatomy (33% vs 65%, P <.05). Radiation patients were less likely to be weaned off parenteral nutrition (PN; 16% vs 41%, P <.05). Cirrhosis/portal hypertension was more frequent in the radiation group (35% vs 11%, P <.05). Radiographic evidence of fatty liver, end-stage liver disease and the risk of cholelithiasis post-SBS were similar in both groups. Conclusions: SBS patients with a history of XRT were more likely to develop cirrhosis and portal hypertension than SBS patients with malignancy alone. Radiation SBS patients were less likely to wean from PN despite more favorable intestinal anatomy.

AB - Patients developing short bowel syndrome (SBS) are at risk for hepatobiliary complications. Radiation enteritis and radiation-induced liver disease are potential complications of radiation therapy (XRT). The authors hypothesized that SBS patients with a history of abdominal XRT would be at increased risk for hepatobiliary complications. Methods: The authors reviewed 92 adult patients developing SBS as a complication of operation for malignancy (n = 37) and/or XRT (n = 55). Hepatobiliary disease was evaluated by liver function tests, radiologic imaging, endoscopy, and histologic studies. Results: Rectal cancer was the most frequent tumor in both groups (36% vs 35%). There were significantly more ovarian cancers (18% vs 3%, P <.05) in the radiation group and fewer desmoid tumors (0% vs 24%, P <.05). Intestinal remnant length was similar, but radiation patients more frequently had colon present (87% vs 62%, P <.05) and were less likely to have type I anatomy (33% vs 65%, P <.05). Radiation patients were less likely to be weaned off parenteral nutrition (PN; 16% vs 41%, P <.05). Cirrhosis/portal hypertension was more frequent in the radiation group (35% vs 11%, P <.05). Radiographic evidence of fatty liver, end-stage liver disease and the risk of cholelithiasis post-SBS were similar in both groups. Conclusions: SBS patients with a history of XRT were more likely to develop cirrhosis and portal hypertension than SBS patients with malignancy alone. Radiation SBS patients were less likely to wean from PN despite more favorable intestinal anatomy.

KW - biliary tract diseases

KW - liver cirrhosis

KW - liver diseases

KW - radiotherapy

KW - short bowel syndrome

UR - http://www.scopus.com/inward/record.url?scp=79960684376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960684376&partnerID=8YFLogxK

U2 - 10.1177/0884533611414028

DO - 10.1177/0884533611414028

M3 - Review article

C2 - 21775643

AN - SCOPUS:79960684376

VL - 26

SP - 474

EP - 478

JO - Nutrition in Clinical Practice

JF - Nutrition in Clinical Practice

SN - 0884-5336

IS - 4

ER -