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Iatrogenic bile duct injuries from biliary tract surgery

Hepatobiliary & Pancreatic Diseases International 2007年第3期6卷 326-329页

作者： Umar Ali Department of surgery First Affiliated Hospital School of MedicineXi'an Jiaotong UniversityXi'an 710061China

BACKGROUND:Cholecystectomy is the most commonly performed procedure in general ***,bile duct injury is a rare but still one of the most common *** injuries sometimes present variably after primary *** detection and appropriate management decrease the morbidity and mortality of the operation. METHODS:Five cases of iatrogenic bile duct injury(IBDI) were managed at the Department of surgery,First Affiliated Hospital,Xi’an Jiaotong *** the cases who underwent both open and laparoscopic cholecystectomy had persistent injury to the biliary tract and were treated accordingly. RESULTS:Recovery of the patients was *** patients were followed-up at the surgical outpatient department for six months to three *** far the patients have shown good recovery. CONCLUSIONS:In cases of IBDI it is necessary to perform the operation under the supervision of an experienced surgeon who is specialized in the repair of bile duct injuries,and it is also necessary to detect and treat the injury as soon as possible to obtain a satisfactory outcome.

关键词： biliary tract surgery iatrogenic bile duct injuries hemorrhage bile leakage

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Disease spectrum and use of cholecystolithotomy in gallstone ileus

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 553-557页

作者： Nicholas E Williams Justin S Gundara Sophia Roser Jaswinder S Samra Upper Gastrointestinal Surgical Unit Royal North Shore HospitalUniversity of SydneySt.LeonardsSydneyNSW 2065Australia

BACKGROUND: Gallstone ileus is a heterogeneous and highly morbid condition that suffers from a lack of consensus regarding the timing and approach to management of the biliary tree and associated fistula. METHODS: We report three cases that demonstrate the spectrum of gallstone ileus with classical examples of both Barnard’s and Bouveret’s syndromes. Clinical presentation diagnostic imaging, surgical technique and outcome are discussed. RESULTS: One patient with Barnard’s syndrome presented with recurrent gallstone ileus. To minimize the risks of complex, definitive biliary surgery and avoid further recurrent episodes, a cholecystolithotomy was performed with effect Two cases of Bouveret’s syndrome were successfully managed with enterolithotomy/cholecystectomy and multivisceral resection respectively, thus highlighting the diverse nature of this disease and management options. CONCLUSIONS: Following enterolithotomy, potentially morbid definitive one-stage surgery in typically compromised, elderly patients needs to be weighed against the risk of recurrence and ongoing biliary pathology. We suggest the use of open cholecystolithotomy for the removal of residual gallstones when the patient is not suitable for definitive biliary surgery.

关键词： cholecystectomy biliary tract disease gallstone ileus biliary tract surgery

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维普期刊数据库

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Middle and long-term clinical outcomes of patients with regional hepatolithiasis after subcutaneous tunnel and hepatocholangioplasty with utilization of the gallbladder

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Hepatobiliary & Pancreatic Diseases International 2005年第4期4卷 597-599页

作者： Xu Li, Li Shi, Yu Wang and Fu-Zhou Tian Department of General surgery, Chengdu Military General Hospital, Chengdu 610083, China Department of General surgery Chengdu Military General Hospital Chengdu 610083 China.

BACKGROUND: Roux-en-Y choledochojejunostomy is routinely performed in patients with regional hepatolithia-sis. However, some of these patients, who have a normal gallbladder and normal Oddi 's sphincter, are unnecessarily undergoing bilio-intestinal drainage. Alternatively, reconstruction can be achieved by subcutaneous tunnel and hepa-tocholangioplasty with the utilization of the gallbladder (STHG). This method is effective to potential endoscopic tunnel and intervention during follow-up, and prevention of reflux cholangitis as well as the disorders of the GI tract. METHODS: The middle and long-term complications of 46 patients who underwent STHG were analyzed. With B-ul-trasonography and biochemical assay, the contraction and concentration function of the gallbladder were also studied. RESULTS: Follow-up showed that all patients survived with a relatively normal life. One patient experienced right epigastric pain, chills and fever because of a stone which impacted in the left hepatic bile duct. Another patient had cholangitis because of biliary ascariasis. The two patients were treated by endoscopic therapy within the subcutaneous gallbladder under local anesthesia. CONCLUSIONS: This operation not only keeps the normal physical functional of the gallbladder, Oddi s sphincter and gastrointestinal tract, but also prevents reflux cholangitis and the disorder of the digestive tract. Hence STHG is a novel operation dealing with regional hepatolithiasis.

关键词： gallbladder biliary tract surgery hepatolithiasis

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