Issue: 2017, Vol. 22, No. 3
IATROGENIC LESIONS OF EXTRAHEPATIC BILIARY DUCTS IN LAPAROSCOPIC CHOLECYSTECTOMY
- iatrogenic lesions of extrahepatic bibliary ducts, diagnosis, operative treatment
- Objective - to estimate the results of the treatment in patients with iatrogenic lesions of extrahepatic bibliary ducts. Material and methods. The authors analyzed the treatment for 113 patients (aged 20-71 years) with iatrogenic lesions of magistral biliary ducts in perfoming laparoscopic cholecystectomy for ordinary cholecystolithiasis, chronic cholecystitis aggravation, cholecystocholedocholithiasis aggravated by mechanical jaundice, acute cholecystitis. Results and сonclusions. Laparoscopic cholecystectomy was performed in ordinary cholecystolithiasis and acute cholecystitis in patients with lesions of extrahepatic biliary ducts. Intraoperatively the lesions of ducts were diagnosed in 25,7% cases only; in other patients - from 14 hours till 8 days after the operation. In spite of the appearance of unfavorable signs in postoperative period (bile production from the drainage, bilirubin level increase) necessary diagnostic trials were often performed with delay. Roux-en-Y hepaticojejunoanastomosis with drainage by Felker were more often performed while diagnosis of lesions of magistral biliary ducts both in laparoscopic cholecystectomy and in postoperative period. In postoperative period within lesion diagnosis laparotomy, abdominal cavity sanation and full outer biliary fistula formation were performed in 14 patients, percutaneous perhepatic drainage of biliary ducts was performed in 10 patients.