Treatment of Iatrogenic Bile Duet Lesions from Laparoseopic Cholecystectomy
Schmidt S.-C, Langrehr J. M., Schumacher G., Neuhaus P.
Klinik fur Allgemein-, Visceral- und Transplantationschirurgie, Universitatsmedizin Berlin, Charitě Campus Virchow Klinikům, BRD |
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Summary:
Injuries of the biliáry tract following laparoseopic cholecystectomy háve inereased with the widespread use of the proceduře. Compared to the conventional open choelycstectomy, the incidence of bile duet injuries is at least twofold higher after the laparoseopic proceduře. A number of risk factors for the occurrence of bile duet injuries háve been well described, including severe inflammation, bleeding, anatomical variations and lack of surgical experience. The appropriate management of bile duet injuries depends on the time of diagnosis after the injury and the type of injury. While peripheral leakages and short strictures can be treated endoscopically, extended injuries and long strictures require surgical reconstruction. The best long-term results are achieved with a a tension-free, end-to-side mucosa-to-mucosa Roux-Y hepaticojejunostomy
Key words:
laparoseopic cholecystectomy - bile duet injury
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