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Titolo:
POSTCHOLECYSTECTOMY BILE-DUCT INJURIES - EXPERIENCE WITH 49 CASES MANAGED BY DIFFERENT THERAPEUTIC MODALITIES
Autore:
WAHAB MA; ELEBIEDY G; SULTAN A; ELGHAWALBY N; FATHY O; ELHAK NG; ELENIN AA; ZID MA; EZZAT F;
Indirizzi:
MANSOURA UNIV,GASTROENTEROL SURG CTR MANSOURA EGYPT
Titolo Testata:
Hepato-gastroenterology
fascicolo: 11, volume: 43, anno: 1996,
pagine: 1141 - 1147
SICI:
0172-6390(1996)43:11<1141:PBI-EW>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
LAPAROSCOPIC CHOLECYSTECTOMY; ENDOSCOPIC TREATMENT; BILIARY-TRACT; STRICTURES; BENIGN;
Keywords:
IATROGENIC BILIARY INJURIES; CHOLECYSTECTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
27
Recensione:
Indirizzi per estratti:
Citazione:
M.A. Wahab et al., "POSTCHOLECYSTECTOMY BILE-DUCT INJURIES - EXPERIENCE WITH 49 CASES MANAGED BY DIFFERENT THERAPEUTIC MODALITIES", Hepato-gastroenterology, 43(11), 1996, pp. 1141-1147

Abstract

Background/Aims: In this study we present our experience in the management of iatrogenic biliary injuries. Forty-nine cases with iatrogenicbiliary injuries were managed in our center during the period from 1984 to 1995. Material and Methods: Forty patients were referred from other hospitals after cholecystectomy, and 9 cases underwent the original operation in our center. Four (0.3 %) of our patients after 1300 conventional cholecystectomy, and 5 (0.9%) cases after 550 Laparoscopic cholecystectomy. Results: The injuries were recognized intraoperativelyin 5 (10%) cases and were immediately repaired 3 cases by axial anastomosis and T-tube drainage, 2 cases by hepatico-jejunostomy (Roux-en-Y). The injuries were detected in the remaining 44 patients postoperatively from one week up to 2 months, the mode of presentation was jaundice in 39 (89%) cases, biliary fistula with or without jaundice and biliary peritonitis were detected in 13 (30%) and in 4 (9%) cases respectively. Eleven (25%) cases were treated endoscopically by sphincterotomy, stent in 8 cases, dilatation, and double stent in true cases, and dilatation using rigid dilators and stent in one case. The remaining 33(75%) cases were treated surgically by hepatico-jejunostomy in 21 (64%) cases, and hepatico-duodenostomy in 12 (36%) cases. No hospital mortality occurred, but late mortality occurred in two (5%) patients after surgery due to biliary restricture with progressive cirrhosis in onecase, and due to advanced colon cancer in the other case, and in one (9%) case after endoscopic treatment. We achieved 87% excellent surgical results during the period of follow-up (36 months), while 80% excellent results were achieved after endoscopic treatment. Good final results (95%, 83%) were achieved after hepatico-jejunostomy and after hepaticoduodenostomy respectively. Conclusion: Postcholecystectomy biliaryinjuries present a surgical problem needing extra efforts and carefulmanagement. Hepatico-jejunostomy appears to be the procedure of choice in repairing these injuries. Immediate surgical repair of bibe duct injury offers excellent results with lower morbidity rates. Endoscopictreatment may be a less invasive technique and have a role in some types of injuries, but needs more time for accurate evaluation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 09:28:13