Use of an opened umbilical vein patch for the reconstruction of the injured biliary tract.
OBJECTIVE
When iatrogenic biliary tract injury occurs, there is the risk of complications such as bile leak and biliary stricture, and hepaticojejunostomy is the conventional procedure used for injury repair. However, this procedure can be complicated by retrograde biliary tract infection and the procedure can destroy the normal anatomical structure.


METHODS
We report here a method of end-to-end biliary tract reconstruction that uses an opened umbilical vein (OUV) patch and two stents to reduce bile leakage and biliary stricture formation following injury to the common bile duct or right main bile duct. The postoperative courses of four patients are reviewed.


RESULTS
In two of the patients, there was a small amount of postoperative bile drainage (for 3 days in the first patient and 2 days in the second patient). Of the two stents, the first stent was removed 1 month postoperatively, and the second stent at 2 to 3 months postoperatively. Three patients have returned to normal activity without symptoms after 44, 62, and 93 months, respectively. One patient died of a liver tumor recurrence in the fifth postoperative month, without a biliary problem.


CONCLUSIONS
An OUV patch for end-to-end biliary reconstruction reduced the volume and duration of bile leakage. Further research is needed to accurately evaluate the stenting period so as to reduce its duration.
Watanabe
Masashi
M
Department of Surgery, Omori Hospital, Toho University School of Medicine, 6-11-1 Omorinishi, Tokyo 143-8541, Japan.
Yamazaki
Kunihiro
K
Tsuchiya
Masaru
M
Otsuka
Yuichiro
Y
Tamura
Akira
A
Shimokawa
Kontoku
K
Kaneko
Hironori
H
Teramoto
Tatsuo
T
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D002758:Cholangiography; D002763:Cholecystectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014471:Umbilical Veins / Q000637:transplantation*