title: [Combined injury of biliary ducts and vessels during cholecystectomy: peculiarities of clinical course and surgical tactics].
abstract: The results of treatment of 56 patients, in whom in 1984-2010 yrs, while performing cholecystectomy, a biliary duct injury have occurred, were analyzed, including 26 (main group)--with combined injury of biliary ducts and brunches of common hepatic artery, 30 (control group)--with isolated complete biliary ducts. High hepaticojejunostomy have constituted the main method of operation in a control group. In the main group in 2 patients there were attempts made to restore the arterial blood flow with subsequent performance of reconstructive intervention on biliary ducts. In 16 (61.5%) patients, due to adequate collateral blood supply presence, the bile outflow was restored using hepaticojejunostomy formation, and in 8 (30.8%)--hepatic resection of various volume was needed, because of hepatic abscesses formation. The results of treatment of patients in these groups have differed not essentially, while applying differentiated approach (positive results were achieved in 93.3 and 84.6% of patients, accordingly). So, in patients with combined injury of biliary ducts and branches of hepatic artery, while performance of cholecystectomy, it is necessary to apply multimodal tactics of treatment, taking into account the peculiarities of clinical course.
authors.forename: M E
authors.initials: ME
authors.lastname: Nichitaĭlo
authors.forename: A V
authors.initials: AV
authors.lastname: Skums
authors.forename: V P
authors.initials: VP
authors.lastname: Shkarban
authors.forename: A I
authors.initials: AI
authors.lastname: Litvin
authors.forename: B L
authors.initials: BL
authors.lastname: Shevchuk
authors.forename: A A
authors.initials: AA
authors.lastname: Skums
mesh_terms: D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery; D002763:Cholecystectomy / Q000009:adverse effects*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006499:Hepatic Artery / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007582:Jejunostomy / Q000379:methods; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome