RESUMO
BACKGROUND: Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur. AIM: To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up. METHODS: Retrospective cohort study with analysis of records of patients undergoing conventional and laparoscopic cholecystectomy. All the patients were analyzed in two years. The only criterion for inclusion was to be operative bile duct injury, regardless of location or time of diagnosis. There were no exclusion criteria. Epidemiological data of patients, time of diagnosis of the lesion and its location were analyzed. RESULTS: Total of 515 patients with gallstones was operated, 320 (62.1 %) by laparotomy cholecystectomy and 195 by laparoscopic approach. The age of patients with bile duct injury ranged from 29-70 years. Among those who underwent laparotomy cholecystectomy, four cases were diagnosed (1.25 %) with lesions, corresponding to 0.77 % of the total patients. No patient had iatrogenic interventions with laparoscopic surgery. CONCLUSION: Laparoscopic cholecystectomy compared to laparotomy, had a lower rate of bile duct injury. .
RACIONAL: A lesão iatrogênica das vias biliares representa a complicação mais temida na colecistectomia e vários são seus fatores desencadeantes. OBJETIVOS: Estudar comparativamente os casos de lesões iatrogênicas de vias biliares ocorridas em colecistectomias convencionais e videolaparoscópicas, avaliando os prováveis fatores causais, complicações e o seguimento pós-operatório. MÉTODO: Estudo de coorte retrospectiva, com análise de prontuários dos pacientes submetidos à colecistectomias convencionais e videolaparoscópicas. Foram analisados todos os pacientes operados no período de dois anos. O critério de inclusão único foi o de existir lesão operatória da via biliar, independentemente de sua localização ou tempo de diagnóstico. Não houve critérios de exclusão. Foram analisados dados epidemiológicos dos pacientes, tempo de diagnóstico da lesão e sua localização. RESULTADOS: Total de 515 pacientes portadores de litíase biliar foi operado, senod 320 (62,1%) por colecistectomia laparotômica e 195 por videolaparoscópica. A idade dos pacientes com lesão de via biliar variou de 29-70 anos. Entre os submetidos à colecistectomia laparotômica, foram diagnosticados quatro casos (1,25%) com lesão de via biliar, correspondendo à 0,77% do total de pacientes. Nenhum paciente teve iatrogênese com a videocirurgia. CONCLUSÃO: A colecistectomia videolaparoscópica, comparativamente à colecistectomia laparotômica, apresentou menor taxa de lesão de via biliar. .
Assuntos
Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Sistema Biliar/lesões , Colecistectomia Laparoscópica , Colecistectomia/métodos , Complicações Intraoperatórias/epidemiologia , Laparotomia , Estudos de Coortes , Doença Iatrogênica , Estudos RetrospectivosRESUMO
BACKGROUND: Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur. AIM: To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up. METHODS: Retrospective cohort study with analysis of records of patients undergoing conventional and laparoscopic cholecystectomy. All the patients were analyzed in two years. The only criterion for inclusion was to be operative bile duct injury, regardless of location or time of diagnosis. There were no exclusion criteria. Epidemiological data of patients, time of diagnosis of the lesion and its location were analyzed. RESULTS: Total of 515 patients with gallstones was operated, 320 (62.1 %) by laparotomy cholecystectomy and 195 by laparoscopic approach. The age of patients with bile duct injury ranged from 29-70 years. Among those who underwent laparotomy cholecystectomy, four cases were diagnosed (1.25 %) with lesions, corresponding to 0.77 % of the total patients. No patient had iatrogenic interventions with laparoscopic surgery. CONCLUSION: Laparoscopic cholecystectomy compared to laparotomy, had a lower rate of bile duct injury.
