Restenotic hepaticojejunostomy secondary to laparoscopic cholecistectomy bile duct injury treated with self- modified Gianturco-Rosh stents.
OBJECTIVE
Laparoscopic cholecystectomy is considered as a standard procedure for symptomatic gallstones. However, the incidence of iatrogenic bile duct injury is higher that the conventional cholecystectomy. In the present study was analyzed the results in 6 patients with iatrogenic bile duct injury during laparoscopic cholecystectomy with restenotic hepaticojejunostomy treated with self-modified Gianturco-Rosch stents.


METHODS
Data were collected retrospectively on May 2000 to October 2008 on six patients with major bile duct injury secondary to cholecystectomy. All patients underwent surgical reconstruction with a Roux-en-Y hepaticojejunostomy and presented clinically as obstructive jaundice. Percutaneous transhepatic and/or endoscopic retrograde cholangiography, cholangioplasty by balloon dilation and biliary catheter placement were done in each patient prior to stents placement. Modified Gianturco-Rosch stents with 3cm length and 10mm diameter were used. Follow-up was obtained with direct patients contact or hospital records.


RESULTS
Metallic stents were successfully implanted in all 6 patients and the mean patency rate was 46.5 months (range = 14-101 months). One patient required percutaneous recanalization procedure for recurrent cholangitis and obstruction.


CONCLUSIONS
Gianturco-Rosch stents placement should be considered in patient with post-hepaticojejunostomy restenosis that repeat surgery is not feasible.
Tsai
Chien-Chung
CC
Department of Radiology, Tainan Municipal Hospital, Tainan City, Taiwan. tsaicc1958@yahoo.com.tw
Chiu
Kuan-Chi
KC
Mo
Lien-Ray
LR
Lin
Ruey-Chang
RC
Chang
Kuo-Kuan
KK
Kuo
Chen-Yuan
CY
Lin
Yie-Wen
YW
Yang
Ta-Ming
TM
Ting
Julius
J
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D001652:Bile Ducts / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects*; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents