[Surgical treatment of iatrogenic bile duct injuries following laparoscopic cholecystectomy: analysis of long-term results. Retrospective clinical study in 51 patients operated in the Campania region from 1991 to 2003].
نویسندگان
چکیده
An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a complex biliary and vascular injury. The postoperative mortality rate of revision surgery was 5/50 (10%). T-tube positioning (n = 20) and Roux-en-Y hepato-jejunostomy (n = 20) were the procedures most frequently performed. The complication rate in patients treated with the T-tube was significantly higher than in those treated with hepatico-jejunostomy. Surgical treatment of biliary injuries following laparoscopic cholecystectomy was characterized by unusually high mortality and morbidity for a non-neoplastic disease. Roux-en-Y hepato-jejunostomy remains the procedure of choice for these injuries.
منابع مشابه
عوارض مجاری صفراوی در کله سیستکتومی لاپاراسکوپیک
Background: The incidence of complications of laparoscopic cholecystectomy has increased dramatically since the introduction and widespread use of laparoscopic cholecystectomy in 1990. Bile duct injuries are among the most important complications of this approach. Methods : From January 1998 to January 2002, a total of 155 laparoscopic cholecystectomy were performed at the Loghman Medical Cent...
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BACKGROUND Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur. AIM To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up. METHODS Retrospective cohort study with ana...
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Introduction: Increase in the common bile duct diameter after cholecystectomy has been reported in animal model. However, similar studies in the human resulted in controversy. Methods: Between 2008 and 2012, fifty two patients with clinical as well as radiological signs and symptoms of gallbladder disease were enrolled in this study. The patients underwent laparoscopic and open cholecystectomy ...
متن کامل[Management of bile duct injuries following laparoscopic cholecystectomy].
INTRODUCTION The aim of the present study is to analyse our experience in the treatment of bile duct injury following laparoscopic cholecystectomy and to propose an algorithm for the management. PATIENTS AND METHODS From January 1990 to March 2002 175 patients with biliary tract injury sustained during laparoscopic cholecystectomy were treated at our institution. We divided the injuries into ...
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ورودعنوان ژورنال:
- Chirurgia italiana
دوره 57 4 شماره
صفحات -
تاریخ انتشار 2005