Management of bile leaks after laparoscopic cholecystectomy
| Autor: | R. C. G. Russell, J. R. Barton, A. R. W. Hatfield |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Hepatic Duct Common medicine Bile Humans Laparoscopy Aged Retrospective Studies Cholangiopancreatography Endoscopic Retrograde Cholestasis medicine.diagnostic_test Bile duct business.industry General surgery Stent Interventional radiology Middle Aged Surgery Sphincterotomy Transduodenal medicine.anatomical_structure Cholecystectomy Laparoscopic Biliary tract Cystic duct Cholecystectomy Female Stents Bile Ducts Biliary Tract Surgical Procedures business Follow-Up Studies |
| Zdroj: | The British journal of surgery. 82(7) |
| ISSN: | 0007-1323 |
| Popis: | The success of laparoscopic cholecystectomy has been tarnished by the increased risk of bile duct damage associated with the operation. Many of these injuries can be managed by endoscopic techniques. Experience of such injuries between 1991 and 1994 was reviewed. Twenty-four patients were referred: 11 with injuries to the cystic duct alone, five with complete hepatic duct obstruction and eight with high bile duct leaks. All patients with leaks from the cystic duct were managed successfully endoscopically (sphincterotomy, four; stent, seven) without recourse to further surgery. Patients with complete obstruction were aided in their recovery by endoscopic and percutaneous techniques, either for postoperative problems (two patients) or in preparation for surgery (three). The eight patients with high bile duct leaks were managed endoscopically by stenting (seven patients) or sphincterotomy (one). Stenting appeared to encourage leaks to heal better than sphincterotomy alone; stents should probably be left in situ for 2 months before removal. There were no deaths and all but one patient had normal biliary function at follow-up. It is suggested that all suspected injuries after biliary surgery require management by a combination of interventional radiology and endoscopic interventional techniques. Surgery may be required only if there is complete obstruction of the biliary tree. |
| Databáze: | OpenAIRE |
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