Document Detail

Hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy. A retrospective study on 51 cases.
MedLine Citation:
PMID:  18265658     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003. METHODOLOGY: The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed. RESULTS: The mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while in 4/51 (7.84%) a biliary stent was positioned. In 1/51 patients (1.9%) a biliary cirrhosis and in 3/51 (5.7%) a bioumoral cholestasis was observed. CONCLUSIONS: Laparoscopic cholecystectomy causes a higher incidence of iatrogenic biliary lesions. Hepaticojejunostomy gives better long-term results and lower morbidity compared to T-Tube plasty. Management of septic complications in patients with iatrogenic biliary lesions represents the first therapeutic step.
Giovanni Conzo; Giuseppe Amato; Luigi Angrisani; Ugo Bardi; Giulio Belli; Umberto Brancaccio; Fulvio Calise; Salvatore Celsi; Francesco Corcione; Diego Cuccurullo; Giuseppe De Falco; Carlo De Werra; Guido De Sena; Giovanni Docimo; Maria Grazia Esposito; Corrado Fantini; Cristiano Giardiello; Antonio Livrea; Michele Lorenzo; Carlo Molino; Mario Musella; Crescenzo Muto; Antonietta Palazzo; Alberto Porcelli; Roberto Rea; Franco Rendano; Michele Santangelo; Walter Santaniello; Luigi Santini; Pasquale Sperlongano; Francesco Stanzione; Alberto Tartaglia; Annunziato Tricarico; Rodolfo Vincenti; Paolo Delrio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  54     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-03-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  2328-32     Citation Subset:  IM    
LAP Club, Gruppo Collaborativo per lo Studio Della Chirurgia Videolaparoscopica Città della Scienza, Napoli, Italy.
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MeSH Terms
Bile Ducts / injuries*
Cholecystectomy, Laparoscopic / adverse effects*
Health Care Surveys
Intraoperative Complications / surgery*
Middle Aged
Retrospective Studies

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