[Transhepatic transanastomotic stents for bile duct injuries. Long-term evolution]. / Férula transhepática-transanastomótica en lesiones de las vías biliares. Evolución a largo plazo.
Cir Cir
; 76(3): 219-23, 2008.
Article
em Es
| MEDLINE
| ID: mdl-18647555
BACKGROUND: With loss of continuity of the bile ducts after injury, surgery is the only feasible treatment option. Roux-en-Y hepatojejunostomy is the best choice. The use of transhepatic and transanastomotic tubes is still controversial. We evaluated patients who were operated on in which a transhepatic, transanastomotic tube was used because the characteristics of the ducts were inadequate. METHODS: We conducted a retrospective, descriptive study between January 1995 and December 2006 for patients with iatrogenic bile duct injuries with a Roux-en-Y hepatojejunostomy and with placement of a transhepatic and transanastomotic tube. Postoperative evolution was analyzed and postoperative cholangitis was considered as failure. RESULTS: We analyzed 74 patients: 66 patients had one tube, five patients had two tubes and three patients had only one but in the right duct. Mean age of patients was 37 years. Twenty portoenterostomies were done. The tube was removed in 55 patients and 11 continued with the tube, having periodic changes with internal-external biliary drainage. In 21% of the cases, a new intervention (either radiological or surgical) was needed. An adequate quality of life was reported by 64.86% of patients. CONCLUSIONS: Anatomic and structural characteristics are unique for each patient. Use of a tube in the reconstructions of bile duct injuries is limited by the surgeon's experience. Characteristics of the ducts are most important. Therefore, selective use is indicated.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ductos Biliares
/
Stents
Tipo de estudo:
Observational_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
Es
Revista:
Cir Cir
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
México