Management of major bile duct injury associated with laparoscopic cholecystectomy

被引：0
作者：
Robinson T.N. [1 ]
Stiegmann G.V. [1 ]
Durham J.D. [2 ]
Johnson S.I. [2 ]
Wachs M.E. [1 ]
Serra A.D. [2 ]
Kumpe D.A. [2 ]
机构：
[1] Department of Surgery, University of Colorado, Health Sciences Center, Denver, CO 80262
[2] Department of Radiology, University of Colorado, Health Sciences Center, Denver, CO 80262
来源：
Surgical Endoscopy | 2001年 / 15卷 / 12期
关键词：
Bile duct injury; Common bile duct; Gallbladder; Laparoscopic cholecystectomy;
D O I：
10.1007/s00464-001-8156-0
中图分类号：
学科分类号：
摘要：
Background: Bile duct injury is a major complication of laparoscopic cholecystectomy. The purpose of this study was to evaluate our management strategy and outcomes for the treatment of such injuries. Methods: We studied 54 consecutive patients who had de novo bile duct injury (n = 20) or prior biliary injury repair (n = 34) associated with laparoscopic cholecystectomy. All patients were managed using a multidisciplinary approach. Results: Definitive operation, almost always Roux-en-Y hepaticojejunostomy, was required in 85% of patients. We inserted external percutaneous biliary catheters in 98% of cases prior to surgery. There were no operative deaths, and the 30-day complication rate was 20%. Eight patients (15%) were managed nonoperatively. Overall, 96% of patients had no long-term, objectively definable biliary sequelae. Conclusions: Treatment of bile duct injury associated with laparoscopic cholecystectomy is optimally done using a multidisciplinary approach. Surgical reconstruction is required in most cases and can be safely accomplished with minimal morbidity and excellent long-term outcomes.
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页码：1381 / 1385
页数：4
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