Liver resection for the treatment of post-cholecystectomy biliary stricture with vascular injury |
| |
Authors: | Marcos V Perini Paulo Herman Andre L Montagnini Jose Jukemura Fabricio F Coelho Jaime A Kruger Telesforo Bacchella Ivan Cecconello |
| |
Affiliation: | Marcos V Perini;Paulo Herman;Andre L Montagnini;Jose Jukemura;Fabricio F Coelho;Jaime A Kruger;Telesforo Bacchella;Ivan Cecconello;Digestive Surgery Division,Depar-tment of Gastroenterology, University of Sao Paulo Medical School; |
| |
Abstract: | AIM:To report experience with liver resection in a select group of patients with postoperative biliary stricture associated with vascular injury.METHODS:From a prospective database of patients treated for benign biliary strictures at our hospital,cases that underwent liver resections were reviewed.All cases were referred after one or more attempts to repair bile duct injuries following cholecystectomy(open or laparoscopic).Liver resection was indicated in patients with Strasberg E3/E4(hilar stricture)bile duct lesions associated with vascular damage(arterial and/or portal),ipsilateral liver atrophy/abscess,recurrent attacks of cholangitis,and failure of previous hepaticojejunostomy.RESULTS:Of 148 patients treated for benign biliary strictures,nine(6.1%)underwent liver resection;eight women and one man with a mean age of 38.6 years.Six patients had previously been submitted to open cholecystectomy and three to laparoscopic surgery.The mean number of surgical procedures before definitive treatment was 2.4.All patients had Strasberg E3/E4injuries,and vascular injury was present in all cases.Eight patients underwent right hepatectomy and one underwent left lateral sectionectomy without mortality.Mean time of follow up was 69.1 mo and after longterm follow up,eight patients are asymptomatic.CONCLUSION:Liver resection is a good therapeutic option for patients with complex postoperative biliary stricture and vascular injury presenting with liver atrophy/abscess in which previous hepaticojejunostomy has failed. |
| |
Keywords: | Abscess Atrophy Benign Bile ducts Cholecystectomy Hepatectomy Stenosis Vascular system injury |
本文献已被 CNKI 等数据库收录! |
|