[Minimally invasive management of biliary leakage after cholecystectomy].

Autor:	Kulikovsky VF; Belgorod State National Research University, Belgorod., Yarosh AL; Belgorod State National Research University, Belgorod., Karpachev AA; St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia., Soloshenko AV; St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia., Nikolayev SB; St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia., Bitenskaya EP; St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia., Linkov NA; St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia., Gnashko AV; Belgorod State National Research University, Belgorod.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2018 (4), pp. 36-40.
DOI:	10.17116/hirurgia2018436-40
Abstrakt:	Aim: To analyze treatment of patients with de novo extrahepatic bile ducts lesions. Material and Methods: The study included 37 patients with post-cholecystectomy biliary leakage which was confirmed intraoperatively and in postoperative period. Cystic duct stump failure was observed in 18 (55.3%) patients, marginal damage, complete intersection and excision of extrahepatic bile duct wall occurred in 7 (18.4%), 1 (2.6%) and 1 (2.6%) patients respectively. Injury of the duct of Lyushka was revelaed in 8 (21.1%) patients. Results and Discussion: Endobiliary stenting was performed in 32 (84.2%) patients. It was final independent method in 5 (13.2%) cases and combined with other procedures in 27 patients (drainage and puncture of bile accumulations (28.9%), laparoscopic external drainage of biliary ducts (42.1%)). The greatest efficacy of these interventions was proved for cystic duct stump failure - 21 of 21 (100.0%), marginal damage of bile ducts - 7% out of 7 (100%), as well as for intersection of ducts of Lychka - 6 out of 8 (75%). Conclusion: Complex application of minimally invasive surgical interventions for extrahepatic bile ducts injury after cholecystectomy reduces likelihood of redo biliary surgery and may be independent treatment in some cases.
Databáze:	MEDLINE
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