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  • Title: [Results of 21 years of surgery in iatrogenic lesions of the bile ducts].
    Author: Palacio-Vélez F, Castro-Mendoza A, Oliver-Guerra AR.
    Journal: Rev Gastroenterol Mex; 2002; 67(2):76-81. PubMed ID: 12214338.
    Abstract:
    OBJECTIVE: To report our results with surgical procedures for treatment of iatrogenic injuries of bile duct. SETTING: Tertiary-level health care hospital. DESIGN: Retrospective, observational, and descriptive study. MATERIAL AND METHOD: We studied all patients operated on due to iatrogenic of injuries of the bile duct over the last 21 years (1980-2001). We analyzed the following variables: age; gender; previous bile duct surgical procedure; auxiliary diagnosis; type of bile duct injury according to Bismuth's classification; surgical procedure used; non-related mortality, and postoperative morbimortality. RESULTS: Fifty four patients were operated on (46 female, eight male) ranging from 19 to 71 years of age; 39 were sent to the hospital, 15 were injured at the hospital in 7,098 gallbladder and bile duct procedures (0.21%), 83.3% in open cholecystectomy, and 16.6% in laparoscopic cholecystectomy. In 86% of cases, diagnosis was made by percutaneous cholangiography and injuries types were: I = 13%, II = 26%, III = 50%, IV = 9.2%, and V = 1.8%. Roux-en-Y intrahepaticojejunostomy was the most common procedure (51.9%) followed by hepaticojejunostomy (37%). Of 54 surgical patients, five died due to situations unrelated to bile duct illness, and they were cared for more than one year without complications; 46 patients (85.2%) did not show strictures, three patients (5.5%) were reoperated on because of strictures, all without recurrent strictures for more than one year of care, with a total of good results of 90.7%; mortality: four patients (7.2%), and complications after procedure: 11%. Strictures were developed during the first year after surgical procedure. CONCLUSION: Our results are similar to others found in researches from Mexico and other countries; therefore, we recommend long-term care of patients.
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