title: Hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy. A retrospective study on 51 cases.
abstract: OBJECTIVE
  Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003.
  
  
  METHODS
  The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed.
  
  
  RESULTS
  The mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while in 4/51 (7.84%) a biliary stent was positioned. In 1/51 patients (1.9%) a biliary cirrhosis and in 3/51 (5.7%) a bioumoral cholestasis was observed.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy causes a higher incidence of iatrogenic biliary lesions. Hepaticojejunostomy gives better long-term results and lower morbidity compared to T-Tube plasty. Management of septic complications in patients with iatrogenic biliary lesions represents the first therapeutic step.
authors.affiliation: LAP Club, Gruppo Collaborativo per lo Studio Della Chirurgia Videolaparoscopica Città della Scienza, Napoli, Italy. giovanni.conzo@unina2.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Amato
authors.forename: Luigi
authors.initials: L
authors.lastname: Angrisani
authors.forename: Ugo
authors.initials: U
authors.lastname: Bardi
authors.forename: Giulio
authors.initials: G
authors.lastname: Belli
authors.forename: Umberto
authors.initials: U
authors.lastname: Brancaccio
authors.forename: Fulvio
authors.initials: F
authors.lastname: Calise
authors.forename: Salvatore
authors.initials: S
authors.lastname: Celsi
authors.forename: Francesco
authors.initials: F
authors.lastname: Corcione
authors.forename: Diego
authors.initials: D
authors.lastname: Cuccurullo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Falco
authors.forename: Carlo
authors.initials: C
authors.lastname: De Werra
authors.forename: Guido
authors.initials: G
authors.lastname: De Sena
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Esposito
authors.forename: Corrado
authors.initials: C
authors.lastname: Fantini
authors.forename: Cristiano
authors.initials: C
authors.lastname: Giardiello
authors.forename: Antonio
authors.initials: A
authors.lastname: Livrea
authors.forename: Michele
authors.initials: M
authors.lastname: Lorenzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Molino
authors.forename: Mario
authors.initials: M
authors.lastname: Musella
authors.forename: Crescenzo
authors.initials: C
authors.lastname: Muto
authors.forename: Antonietta
authors.initials: A
authors.lastname: Palazzo
authors.forename: Alberto
authors.initials: A
authors.lastname: Porcelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Rea
authors.forename: Franco
authors.initials: F
authors.lastname: Rendano
authors.forename: Michele
authors.initials: M
authors.lastname: Santangelo
authors.forename: Walter
authors.initials: W
authors.lastname: Santaniello
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sperlongano
authors.forename: Francesco
authors.initials: F
authors.lastname: Stanzione
authors.forename: Alberto
authors.initials: A
authors.lastname: Tartaglia
authors.forename: Annunziato
authors.initials: A
authors.lastname: Tricarico
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Vincenti
authors.forename: Paolo
authors.initials: P
authors.lastname: Delrio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies