Document Detail

The therapy of iatrogenic lesions of the bile duct.
MedLine Citation:
PMID:  2083927     Owner:  NLM     Status:  MEDLINE    
Forty-three patients were operated on for iatrogenic lesions of the bile duct. Only one patient had a biliary lesion which occurred in the course of distal gastric resection. All other lesions were observed during cholecystectomy. Injury of the bile duct was detected intraoperatively in sixteen cases. In 10 patients, lesions were observed in the postoperative period and in 17 patients, the post-operative diagnosis was made on the basis of symptoms of stenosis of the bile duct. Satisfactory results can be obtained by suturing the common bile duct and splinting with a T-tube where the lesion is partial and detected in the course of surgery. In the case of patients with strictures, an anastomosis (choledochojejunostomy Roux-en-Y loop) should be performed. Strictures involving hepatic bifurcation and the right hepatic duct have a higher incidence of restenosis, and transhepatic splinting of the anastomosis can therefore produce better results. Long-term transhepatic drainage has the advantage that replacement of the drain is relatively straightforward and complete dislocation impossible. Four of our patients died postoperatively, three of multiple septic organ failure due to preoperative biliary peritonitis or cholangitis, and one of a pulmonary embolism. Satisfactory long-term results after correction of an iatrogenic lesion of the bile duct can be obtained if the corrective procedure is undertaken immediately, prior to the onset of biliary cirrhosis.
F Schulz; R Függer; F Herbst; I Huk
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  37 Suppl 2     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-05-14     Completed Date:  1991-05-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  IM    
First Clinic of Surgery, Vienna University, Austria.
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MeSH Terms
Aged, 80 and over
Bile Ducts / injuries*,  surgery*
Common Bile Duct / injuries,  pathology,  surgery
Constriction, Pathologic / surgery
Iatrogenic Disease
Middle Aged

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