SURGICAL APPROACH AT IATROGENIC INJURIES OF EXTRAHEPATIC BILIARY TRACTS

Abstract

Aim: To study the efficiency of reconstructive operations in “recent” iatrogenic injuries of extrahepatic biliary tracts. Methods. The experiment on surgical treatable of 22 patients with iatrogenic “recent” injuries of extrahepatic biliary tracts is submitted. Primary reparative operation has been performed to 1 patient (suturing of hepaticocholedochus injury after Laparoscopic cholecystectomy). Reparative operations throughout Roux-en-Y biliodigestive anastomosis were performed to 19 patients (Roux-en-Y hepaticojejunostomy - 4, Roux-en-Y bihepaticojejunostomy - 13, Roux-en-Y trihepaticojejunostomy - 2). The external drainage of extrahepatic biliary tracts of the 2nd patient has been the final method of surgical treatable. Results.Post-surgery complaints and mortalities. Among all the 22 patients with iatrogenic injuries of extrahepatic biliary tracts the post-surgery complaints of 4 patients have been registered: failure of stitches of Roux-en-Y bihepaticojejunostomy - 1, acute adhesive small bowel obstruction - 1, stenosis of bihepaticojejunostomy - 1, purulence of surgical wound - 1. Post-surgery mortality is 4,5 %. Conclusion.Roux-en-Y biliodigestive surgery is the main conclusive method in reconstructive treatment of iatrogenic injuries of extrahepatic biliary tracts.