Mercado-Díaz MÁ, Ramírez-Morales R, Medinilla-Cruz MA, Poucel-Sánchez MF

Language: Spanish
References: 22
Page: 219-223
PDF size: 80.82 Kb.

ABSTRACT

Background: With loss of continuity of the bile ducts after injury,surgery is the only feasible treatment option. Roux en Yhepatojejunostomy is the best choice. The use of transhepaticand transanastomotic tubes is still controversial. We evaluatedpatients who were operated on in which a transhepatic,transanastomotic tube was used because the characteristics ofthe ducts were inappropriate.
Methods: This was a retrospective, descriptive study conductedbetween January 1995 and December 2006 for patients withiatrogenic bile duct injuries with a Roux en Y hepatojejunostomyand with placement of a transhepatic and transanastomotic tube.Postoperative evolution was analyzed and postoperativecholangitis was considered as failure.
Results: We analyzed 74 patients, 66 patients had one tube, 5patients had two tubes and 3 patients had only one but in theright duct. Mean age of patients was 37 years. Twentyportoenterostomies were done. The tube was removed in 55patients and 11 continue with the tube, having periodic changeswith internal-external biliary drainage. In 21% of the cases a newintervention (either radiological or surgical) was needed. Anadequate quality of life was reported by 64.9% of the patients.
Conclusions: Anatomical and structural characteristics areunique for each patient. Use of a tube in the reconstructions ofbile duct injuries is limited to surgeon’s experience. Characteristicsof the ducts are most important. Therefore, selective use isindicated.

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