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Khirurgiia (Mosk) ; (4): 36-40, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29697681

RESUMO

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.


Assuntos
Fístula Anastomótica , Ductos Biliares , Doenças Biliares/cirurgia , Colecistectomia Laparoscópica , Complicações Intraoperatórias/prevenção & controle , Complicações Pós-Operatórias , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Fístula Anastomótica/cirurgia , Ductos Biliares/lesões , Ductos Biliares/cirurgia , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Reoperação/métodos , Estudos Retrospectivos , Federação Russa , Resultado do Tratamento
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