IATROGENIC INJURIES ON THE BILIARY-TRACT

The purpose of this report was to present a 40-year experience in biliary surgery, with special reference to a serious and dangerous problem which involves mainly the surgeon's responsibility: the iatrogenic injuries on the biliary system, with the risk of occurrence of biliary tract obstructions. This report describes the adverse events due to negligence during surgical practice and their severe surgical sequelae among patients who were treated surgically for biliary tract diseases. Patients were classified On two separate groups: a first group, characterized by patients who had previously required surgery and developed a transient or intermittent obstruction, and a second group, with those patients who suffered permanent or complete strictures. The author's statistic includes 17 intermittent lesions and 40 permanent obstructions, that is a total of 57 patients. Clinical symptoms, pathogenesis and pathological variables are described in detail, with emphasis on the imaging techniques, being the transparieto-hepatic cholangiography the most generally suitable procedure for the radiographic diagnosis, and this is well documented in the article. A future report discusses the surgical approach and results, prediction of prognosis and complications.