Surgical therapy of iatrogenic lesions of biliary tract

Steven A. Ahrendt, Henry A. Pitt

Research output: Contribution to journalArticle

Abstract

Iatrogenic injuries of the biliary tract have increased in incidence over the past decade with the introduction of laparoscopic cholecystectomy. Although a number of factors have been identified with a higher risk of injury (male gender, complicated gallstone disease, aberrant anatomy) and a number of technical steps have been emphasized to avoid these injuries, the incidence of bile duct injuries has reached a steady-state at least double the rate observed with open cholecystectomy. Most patients sustaining a bile duct injury are recognized in the weeks following laparoscopic cholecystectomy. Careful preoperative preparation should include control of sepsis by draining any bile collections or fistulas and complete cholangiography. Long-term results are best achieved in specialized hepatobiliary centers performing biliary reconstruction with a Roux-en-Y hepaticojejunostomy. Success rates over 90% have been reported from several centers to date with intermediate follow-up.

Original languageEnglish (US)
Pages (from-to)1360-1365
Number of pages6
JournalWorld journal of surgery
Volume25
Issue number10
DOIs
StatePublished - Oct 22 2001

ASJC Scopus subject areas

  • Surgery

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