Document Detail


Iatrogenic Biliary Injuries: Multidisciplinary Management in a Major Tertiary Referral Center.
MedLine Citation:
PMID:  25435672     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. Iatrogenic biliary injuries are considered as the most serious complications during cholecystectomy. Better outcomes of such injuries have been shown in cases managed in a specialized center. Objective. To evaluate biliary injuries management in major referral hepatobiliary center. Patients & Methods. Four hundred seventy-two consecutive patients with postcholecystectomy biliary injuries were managed with multidisciplinary team (hepatobiliary surgeon, gastroenterologist, and radiologist) at major Hepatobiliary Center in Egypt over 10-year period using endoscopy in 232 patients, percutaneous techniques in 42 patients, and surgery in 198 patients. Results. Endoscopy was very successful initial treatment of 232 patients (49%) with mild/moderate biliary leakage (68%) and biliary stricture (47%) with increased success by addition of percutaneous (Rendezvous technique) in 18 patients (3.8%). However, surgery was needed in 198 patients (42%) for major duct transection, ligation, major leakage, and massive stricture. Surgery was urgent in 62 patients and elective in 136 patients. Hepaticojejunostomy was done in most of cases with transanastomotic stents. There was one mortality after surgery due to biliary sepsis and postoperative stricture in 3 cases (1.5%) treated with percutaneous dilation and stenting. Conclusion. Management of biliary injuries was much better with multidisciplinary care team with initial minimal invasive technique to major surgery in major complex injury encouraging early referral to highly specialized hepatobiliary center.
Authors:
Ibrahim Abdelkader Salama; Hany Abdelmeged Shoreem; Sherif Mohamed Saleh; Osama Hegazy; Mohamed Housseni; Mohamed Abbasy; Gamal Badra; Tarek Ibrahim
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-10
Journal Detail:
Title:  HPB surgery : a world journal of hepatic, pancreatic and biliary surgery     Volume:  2014     ISSN:  0894-8569     ISO Abbreviation:  HPB Surg     Publication Date:  2014  
Date Detail:
Created Date:  2014-12-1     Completed Date:  -     Revised Date:  2014-12-2    
Medline Journal Info:
Nlm Unique ID:  9002972     Medline TA:  HPB Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  575136     Citation Subset:  -    
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