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- Title
Férula transhepática-transanastomótica en lesiones de las vías biliares. Evolución a largo plazo.
- Authors
Mercado-Díaz, Miguel Ángel; Ramírez-Morales, Rebeca; Medinilla-Cruz, Mario Arturo; Poucel-Sánchez Medal, Fernando
- Abstract
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 inappropriate. Methods: This was a retrospective, descriptive study conducted 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, 5 patients had two tubes and 3 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 continue 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 64.9% of the patients. Conclusions: Anatomical and structural characteristics are unique for each patient. Use of a tube in the reconstructions of bile duct injuries is limited to surgeon's experience. Characteristics of the ducts are most important. Therefore, selective use is indicated.
- Subjects
BILE ducts; JEJUNOSTOMY; ENTEROSTOMY; INTESTINAL surgery; SURGERY; WOUNDS &; injuries
- Publication
Cirugía y Cirujanos, 2008, Vol 76, Issue 3, p219
- ISSN
0009-7411
- Publication type
Article