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2009, Number 4

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Rev Med Hosp Gen Mex 2009; 72 (4)

Injury to the extrahepatic biliary ducts and options for surgical management in a pediatric population. Report of ten cases

Santos-Jasso K, Asz-Sigall J, Medina-Vega A, Sainz-Castro R

Language: Spanish
References: 19
Page: 187-194
PDF size: 202.53 Kb.


ABSTRACT

Extrahepatic bile duct injury can occur during any upper abdominal surgery, mainly during laparoscopic cholecystectomy. These lesions are infrequent in the pediatric age group. They occur during elective and urgent cases, usually as a result of inadequate identification and exposure of the extrahepatic bile duct. Other injuries as bile duct stenosis can occur due to excessive tissue manipulation during the dissection of the biliary tree when repairing congenital pathology such as choledocal cyst. The most challenging issue is the early recognition and repair of these lesions to avoid major sequelae (metabolic disorders and secondary biliary cirrhosis). There are many surgical options for these patients that should be individualized, most of them with good results. Roux-en-Y hepato-jejunostomy is the preferred technique, nevertheless the Kasai portoenterostomy and the cholecystoenterostomy are good options for high bile duct injuries in small children when an adequate hepato-enterostomy cannot be done.


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