OBJECTIVE: Bile Duct Injury (BDI) is one of the most serious complications of cholecystectomy. The authors analyzed the clinical presentation, surgical management and long-term outcome of 19 patients presenting with iatrogenic major BDIs (Straburg type E) following cholecystectomy who underwent Roux-en-Y hepaticojejunostomy. MATERIAL AND METHOD: Between 1992 and 2005, 19 patients with major BDIs (Strasberg type E) following cholecystectomy were included. Operative notes and charts of all patients were reviewed systematically. A follow-up examination of each patient was performed after a median of 22 months (range 1-120). RESULTS: Twelve patients presented with ascending cholangitis, two patients were referred to the hospital with biliary-cutaneous fistula and five patients (26.3%) were identified at the time of operations. All patients were treated with Roux-en-Y hepaticojejunostomy with at least 2 cm of the diameter of the biliary-enteric anastomosis. There was no postoperative mortality. Postoperative complication was found in 5 patients (26.3%). Until now, during the follow-up, neither clinical nor biochemical evidence of recurrent cholangitis has been found. CONCLUSION: Major BDIs are associated with high morbidity rate and prolonged hospitalization. Early detection and referral to an experienced center is crucial in the management of these patients. Roux-en-Y hepaticojejunostomy with large diameter of the biliary-enteric anastomosis is the surgical procedure of choice with good long-term outcome.
OBJECTIVE:Bile Duct Injury (BDI) is one of the most serious complications of cholecystectomy. The authors analyzed the clinical presentation, surgical management and long-term outcome of 19 patients presenting with iatrogenic major BDIs (Straburg type E) following cholecystectomy who underwent Roux-en-Y hepaticojejunostomy. MATERIAL AND METHOD: Between 1992 and 2005, 19 patients with major BDIs (Strasberg type E) following cholecystectomy were included. Operative notes and charts of all patients were reviewed systematically. A follow-up examination of each patient was performed after a median of 22 months (range 1-120). RESULTS: Twelve patients presented with ascending cholangitis, two patients were referred to the hospital with biliary-cutaneous fistula and five patients (26.3%) were identified at the time of operations. All patients were treated with Roux-en-Y hepaticojejunostomy with at least 2 cm of the diameter of the biliary-enteric anastomosis. There was no postoperative mortality. Postoperative complication was found in 5 patients (26.3%). Until now, during the follow-up, neither clinical nor biochemical evidence of recurrent cholangitis has been found. CONCLUSION: Major BDIs are associated with high morbidity rate and prolonged hospitalization. Early detection and referral to an experienced center is crucial in the management of these patients. Roux-en-Y hepaticojejunostomy with large diameter of the biliary-enteric anastomosis is the surgical procedure of choice with good long-term outcome.
Authors: Nicola de'Angelis; Fausto Catena; Riccardo Memeo; Federico Coccolini; Aleix Martínez-Pérez; Oreste M Romeo; Belinda De Simone; Salomone Di Saverio; Raffaele Brustia; Rami Rhaiem; Tullio Piardi; Maria Conticchio; Francesco Marchegiani; Nassiba Beghdadi; Fikri M Abu-Zidan; Ruslan Alikhanov; Marc-Antoine Allard; Niccolò Allievi; Giuliana Amaddeo; Luca Ansaloni; Roland Andersson; Enrico Andolfi; Mohammad Azfar; Miklosh Bala; Amine Benkabbou; Offir Ben-Ishay; Giorgio Bianchi; Walter L Biffl; Francesco Brunetti; Maria Clotilde Carra; Daniel Casanova; Valerio Celentano; Marco Ceresoli; Osvaldo Chiara; Stefania Cimbanassi; Roberto Bini; Raul Coimbra; Gian Luigi de'Angelis; Francesco Decembrino; Andrea De Palma; Philip R de Reuver; Carlos Domingo; Christian Cotsoglou; Alessandro Ferrero; Gustavo P Fraga; Federica Gaiani; Federico Gheza; Angela Gurrado; Ewen Harrison; Angel Henriquez; Stefan Hofmeyr; Roberta Iadarola; Jeffry L Kashuk; Reza Kianmanesh; Andrew W Kirkpatrick; Yoram Kluger; Filippo Landi; Serena Langella; Real Lapointe; Bertrand Le Roy; Alain Luciani; Fernando Machado; Umberto Maggi; Ronald V Maier; Alain Chichom Mefire; Kazuhiro Hiramatsu; Carlos Ordoñez; Franca Patrizi; Manuel Planells; Andrew B Peitzman; Juan Pekolj; Fabiano Perdigao; Bruno M Pereira; Patrick Pessaux; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Luca Portigliotti; Raffaele Romito; Boris Sakakushev; Behnam Sanei; Olivier Scatton; Mario Serradilla-Martin; Anne-Sophie Schneck; Mohammed Lamine Sissoko; Iradj Sobhani; Richard P Ten Broek; Mario Testini; Roberto Valinas; Giorgos Veloudis; Giulio Cesare Vitali; Dieter Weber; Luigi Zorcolo; Felice Giuliante; Paschalis Gavriilidis; David Fuks; Daniele Sommacale Journal: World J Emerg Surg Date: 2021-06-10 Impact factor: 5.469