[Surgical correction of bile duct injuries after laparoscopic cholecystectomy].
The rate of iatrogenic bile duct lesions has raised up to 3.5% after the introduction of laparoscopic cholecystectomy. Lesions that can not be managed endoscopically require surgical intervention. In this study 12 patients that presented with iatrogenic bile duct lesions following laparoscopic cholecystectomy and underwent reconstructive surgery at our institution are included. In nine patients a hepaticojejunostomy was performed, whereas two patients underwent end-to-end anastomosis. In one patient the lesion was oversewn. There were no complications postoperatively. After a median follow-up of 24,5 months (SD +/- 8 months) all patients are without symptoms. However, in two patients a postoperative endoscopic stenting for 4 months was necessary for bouginage. Reconstructive surgery, mainly hepaticojejunostomy in bile duct lesions is a safe and efficacious treatment of endoscopic treatment failure.
Hosch
S B
SB
Abteilung für Allgemeinchirurgie, Universitätskrankenhaus Hamburg-Eppendorf.
Zornig
C
C
Izbicki
J R
JR
Prenzel
K L
KL
Thonke
F
F
Broelsch
C E
CE
D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000601:surgery; D003135:Common Bile Duct / Q000293:injuries / Q000601:surgery; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007583:Jejunum / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome
Operative Korrektur von Gallengangsverletzungen nach laparoskopischer Cholezystektomie.