Iatrogenic injury in videolaparoscopic cholecystectomy: difficult surgical correction biliary tract.
Two cases of biliary tract serious lesions during videolaparoscopic cholecystectomy are reported. In the first case of lithiasic cholecystitis there had been a complete damage of the common biliary duct; in the second case there had been a double main biliary duct binding with removal of a biliary tract segment. In both cases a biliary confluence-jejunal anastomosis with Roux-en-Y loop was made up. In the first one the operation was difficult because of the main bile duct's fragility and modest expansion. In the second one the presence of a secondary biliary duct in gallbladder fossa not recognized, but drained outside with a common drainage placed during the operation prevented appearance of jaundice with dilatation of biliary ducts. It was heavily conditioned performing confluence-jejunal anastomosis with Roux-en-Y loop. The post-operative course was characterized by appearance of an external biliary fistula which has spontaneously disappeared. One year later, neither of the two patients had any stenosis or cholangitis problems.
Doldi
S B
SB
Cattedra di Chirurgia Generale I, Universita degli Studi di Milano, Casa di Cura S. Ambrogio, Italy.
Marinoni
M
M
Mozzi
E
E
Longoni
F
F
Zappa
M A
MA
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D017734:Bile Ducts, Extrahepatic / Q000293:injuries* / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D003135:Common Bile Duct / Q000293:injuries / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000293:injuries / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D017562:Postcholecystectomy Syndrome / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D013525:Surgical Instruments; D014741:Video Recording / Q000295:instrumentation*