Experience in dealing with iatrogenic bile duct injury due to laparoscocpic cholecystecomy

VernacularTitle:胆囊切除致胆道损伤的处理经验
Author: Mingjun TANG ; Jianguo MIAO ; Tao CHEN ; Fuzhou TIAN ; Jianfeng CUI
Publication Type:Journal Article
Keywords: Cholecystectomy; Wounds and injury; Protoenterostomy,hepatic; Anastomosis
From: Chinese Journal of General Surgery 2011;26(8):638-640
CountryChina
Language:Chinese
Abstract: Objective To explore the diagnosis and treatment of iatrogenic bile duct injury during choledochocystectomy. Methods Clinical data of 24 cases of iatrogenic bile duct injury were analyzed retrospectively from 2005 to 2009. Results Eight patients underwent early repair of bile duct within 4 days after the injury. 14 patients with later recognized bile duct injury underwent selective operations, and two patients were discharged after their jaundice were relieved without any surgical treatment. Supporting T tubes were left in place in 22 patients for 8 to 14 months after operations, without any biliary obstruction found after one year and six months to five year follow-up. Conclusions Early bile duct injury within 4 days was easily treated, but later bile duct injury should have selective operation. The patients with jaundice could be diagnosed with PTCD and ERCP to observe the bile duct injury. During operation membrane-to-membrane wide hepatojejunostomy helps prevent later anastomotic stenosis. The left in drainage tube in anastomotic stoma for more than 8 months improves success rate in the process of injuried bile duct repair.