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- W4239945375 abstract "Background: Bile duct injuries (BDI) after laparoscopic cholecistectomy commonly occur close to the hilar plate. Hepatico-jejunostomy (HJ) according to Hepp-Couinaud (HC) technique in referral centers remains the best surgical treatment. Methods: 186 patients (pts) referred for BDI between 1994 and 2014, 163 pts (87.6%) for major BDI. Eighty-nine (47.8%) underwent surgical repair: 82 HJHC and 7 multiple-HJ. Aims of this study were: evaluate predictive factors of failure of biliary recostruction, long term results after surgery and after percutaneous stenting (PTC) in postoperative strictures. Repair was defined successful when no further treatment was required. Symptom-free Survival (SFS) after surgery and Progression Symptom-free Survival (PSFS) after PTC of stricture were evaluated. Results: Postoperative morbidity was 34.8% with no mortality. After a mean follow-up of 96 months, 76 pts (85,4%) had excellent/good outcome. Thirteen pts (14.6%) developed anastomotic stricture treated with PTC. Post-operative bile leakage was the only factor significantly related to a failure of biliary reconstruction (p = 0.03; HR:4.963). Ten-years SFS was 82%. At the end of PTC treatment 8 pts (61%) reached excellent/good results with 10-years PSFS of 92.4% (p = 0.049%). Conclusion: Success of biliary reconstruction after BDI is related to development of postoperative bile leakage. Ten-year survival without symptoms was 82% after surgery and it was significantly increased to more than 92% after PTC management of failed repairs." @default.
- W4239945375 created "2022-05-12" @default.
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- W4239945375 date "2019-01-01" @default.
- W4239945375 modified "2023-09-30" @default.
- W4239945375 title "Surgical repair for bile duct injuries after cholecistectomy in a tertiary referral center: long term results" @default.
- W4239945375 doi "https://doi.org/10.1016/j.hpb.2019.10.136" @default.
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