title: Restenotic hepaticojejunostomy secondary to laparoscopic cholecistectomy bile duct injury treated with self- modified Gianturco-Rosh stents.
abstract: 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.
authors.affiliation: Department of Radiology, Tainan Municipal Hospital, Tainan City, Taiwan. tsaicc1958@yahoo.com.tw
authors.forename: Chien-Chung
authors.initials: CC
authors.lastname: Tsai
authors.forename: Kuan-Chi
authors.initials: KC
authors.lastname: Chiu
authors.forename: Lien-Ray
authors.initials: LR
authors.lastname: Mo
authors.forename: Ruey-Chang
authors.initials: RC
authors.lastname: Lin
authors.forename: Kuo-Kuan
authors.initials: KK
authors.lastname: Chang
authors.forename: Chen-Yuan
authors.initials: CY
authors.lastname: Kuo
authors.forename: Yie-Wen
authors.initials: YW
authors.lastname: Lin
authors.forename: Ta-Ming
authors.initials: TM
authors.lastname: Yang
authors.forename: Julius
authors.initials: J
authors.lastname: Ting
mesh_terms: 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