[Results of 21 years of surgery in iatrogenic lesions of the bile ducts].
OBJECTIVE
To report our results with surgical procedures for treatment of iatrogenic injuries of bile duct.


METHODS
Tertiary-level health care hospital.


METHODS
Retrospective, observational, and descriptive study.


METHODS
We studied all patients operated on due to iatrogenic of injuries of the bile duct over the last 21 years (1980-2001). We analyzed the following variables: age; gender; previous bile duct surgical procedure; auxiliary diagnosis; type of bile duct injury according to Bismuth's classification; surgical procedure used; non-related mortality, and postoperative morbimortality.


RESULTS
Fifty four patients were operated on (46 female, eight male) ranging from 19 to 71 years of age; 39 were sent to the hospital, 15 were injured at the hospital in 7,098 gallbladder and bile duct procedures (0.21%), 83.3% in open cholecystectomy, and 16.6% in laparoscopic cholecystectomy. In 86% of cases, diagnosis was made by percutaneous cholangiography and injuries types were: I = 13%, II = 26%, III = 50%, IV = 9.2%, and V = 1.8%. Roux-en-Y intrahepaticojejunostomy was the most common procedure (51.9%) followed by hepaticojejunostomy (37%). Of 54 surgical patients, five died due to situations unrelated to bile duct illness, and they were cared for more than one year without complications; 46 patients (85.2%) did not show strictures, three patients (5.5%) were reoperated on because of strictures, all without recurrent strictures for more than one year of care, with a total of good results of 90.7%; mortality: four patients (7.2%), and complications after procedure: 11%. Strictures were developed during the first year after surgical procedure.


CONCLUSIONS
Our results are similar to others found in researches from Mexico and other countries; therefore, we recommend long-term care of patients.
Palacio-Vélez
Fernando
F
Hospital Regional General Ignacio Zaragoza, ISSSTE.
Castro-Mendoza
Antonio
A
Oliver-Guerra
Angel Ricardo
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D002648:Child; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors