The role of MR cholangiopancreatography in preoperative assessment for repair of major iatrogenic biliary injury: 10-year experience.
Hepatogastroenterology
; 61(136): 2163-6, 2014.
Article
em En
| MEDLINE
| ID: mdl-25699342
ABSTRACT
BACKGROUND/AIMS:
Major iatrogenic biliary injury is a potentially life-threatening complication after laparoscopic cholecystectomy. Early diagnosis is essential to improve outcomes, however, to date, there is no consensus regarding the best imaging approach for preoperative assessment of these injuries.METHODOLOGY:
From March 2002 to February 2012, 40 patients with postoperative major biliary injury underwent biliary reconstruction at our Institution. Mean age was 51.7 ± 18.1 years (19-86) with 30 (75%) females. Magnetic resonance cholangiopancreatography (MRCP) were compared with different diagnostic modalities and definitive intraoperative findings.RESULTS:
Of 40 patients, 10 (25%) had Bismuth type I, 10 (25%) Bismuth type II, 6 (15%) Bismuth type III injury, 10 (25%) Bismuth type IV and, 4 (10%) Bismuth type V. MRCP has similar accuracy to define injury site, but is superior in delineating proximal ductal anatomy that was often not visualized with endoscopic retrograde cholangiopancreatography (ERCP).CONCLUSION:
MRCP is a reliable, accurate and readily available diagnostic tool to assess complex biliary injuries. It provides adequate visualization of the proximal and distal biliary trees and may be considered as first-line test in the management of major iatrogenic biliary injuries. Revision of current guidelines for diagnostic approach of this condition is warranted.
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Cuidados Pré-Operatórios
/
Colecistectomia Laparoscópica
/
Colangiopancreatografia por Ressonância Magnética
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article