Buradasınız

Anasayfa » Content

Açık kolesistektomilerde iatrojenik biliyer sistem yaralanmaları (13 olguluk analiz)

Iatrogenic biliary system injuries in open cholecystectomies: analysis of 13 cases

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1994

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Biliary injuries, from the point of high morbidity and mortality, are the most important complications in open cholecystectomy. In this study, 13 patients who have biliary injuries were examined in our clinic. There were 5 patients in group I (intraoperative) and 8 patients in group II (postoperative). There were mostly type I injuries according to Bismuth classification /group I: 2(40%). group II: 3(37,5%)]. Biochemical tests, USG, (1 and PTC were used for diagnosis. In 2 (40%) patients choledochoplasty t T tube and in 6 (75%) patients Roux-en Y hepatico choledocho-jejunostomy were performed in group I and group II respectively. The results were satisfactory in both groups of patients whom stents were used. In one case which primary repair without stent was performed, biliary fistula occured. In one case whom stent was not used in group II. recurrent cholangitis developed. Biliary injuries must be evaluated carefully. Application stent has many advantage. In elective surgery. Roux-en Y anastomosis seems to be ideal operation. [Journal of Turgut Özal Medical Center 1(3): 198-203.1994]
Bookmark/Search this post with
Abstract (Original Language): 
Açık kolesistektomilerde biliyer yaralanmalar morbidite ve mortalite açısından en önemli komplikasyonlardır. Çalışmada kliniğimizde biliyer yaralanma nedeniyle takip ve tedavi uygulanan 13 hasta değerlendirildi. Grup I'de (intraoperatif) 5, Grup 11"de (postoperatif) 8 hasta mevcuttu. Bismuth sınıflamasına göre en çok Tip I şeklinde yaralanma mevcuttu [Grup 1: 2(%40); Grup II: 3 (%37,5)J. Tanıda biyokimyasal tetkikler. İ'SG (Hltrasonografı), C'T (Kompüterize tomografi) ve PTK (Perkütan transhepatik kolanjiografi) kullanıldı.Grup I'deki hastaların 2'sine (%40) koledokoplasti •+ T tüp uygulanırken, grup Il'deki hastaların 6'sına (%75) Roux-en Y hepatiko/koledoko-jejunostomi uygulandı. Her iki grupta stent uygulanan hastalarda sonuçlar oldukça iyi idi. Stentsiz primer tamir yapılan 1 olguda biliyer fistül gelişti. Grup ll'de stentsiz I olguda rekürrent kolanjit gelişti. Biliyer yaralanmalar dikkatli değerlendirilmelidir. Stent kullanımı avantajlıdır. Elektif cerrahide Roux-en Y tipi anastomoz ideal ameliyat olarak gözükmektedir. [Turgut Özal Tıp Merkezi Dergisi 1(3): 198-203,1994]
FULL TEXT (PDF): 
PDF icon arastirmax-acik-kolesistektomilerde-iatrojenik-biliyer-sistem-yaralanmalari-13-olguluk-analiz.pdf
  • 3
198-203
  • Turkish

REFERENCES

References: 

1. Andren-Sandberg A, Alınder G, Bengmark S. Accidental lesions of the common bile duct at cholecystectomy: Pre-and perioperative factors of importance. Ann Surg 1985; 201: 328-32.
2 Lindenauer SM. Surgical treatment of bile duct strictures. Surgery 1973; 73: 875-80.
3 Hillıs TM, Westbrook KC, Caldwell FT, Read RC. Surgical injury at the common bile duct. Am J Surg 1977; 134: 712-6.
4 Pitt HA, Kaufman SL, Coleman J, et al. Benign postoperative biliary strictures. Ann Surg 1989; 210: 417-25
5 Lillemoe KD, Pitt AH, Cameron JL Postoperative bile duct strictures. Surg Clin North Am 1990; 70: 1355-75.
6. Genest JF, Nanos E, Grundfest-Broniatowski S, et al. Benign biliary strictures: An analytic review (1974 to 1984) Surgery 1986; 99: 409-13.
7. Huıbregtse K, Katon RM, Tytgat GNJ. Endoscopic treatment of postoperative biliary strictures Endoscopy 1986; 18: 133-7.
8. Williams HJ, Bender CE, Mayv GR. Benign postoperative biliary strictures: Dilatation with fluoroscopic guidance Radiology 1987; 163: 629-34.
9. Pitt HA, Miyamoto T, Parapatis SK, et al. Factors influencing outcome in patients with postoperative biliary strictures. Am J Surg 1982; 144: 14-21.
10. Browder IW, Dowling JB, Koontz K, et al Early management of operative injuries of the extrahepatic biliary tract. Ann Surg 1987; 205: 649-56.
11. Braasch JW, Bolton JS, Rossi RL A technique of biliary tract reconstruction with complete follow-up in 44 consecutive cases. Ann Surg 1981; 194: 635-38.
12 Vallon AG, Mason RR, Laurence BH, et al Endoscopic retrograde cholangiography in postoperative bile duct strictures. Br J Radiol 1982; 55: 32-5.
13. Pellegrini CA, Thomas JM, Way LW Recurrent biliary stricture: Am J Surg 1984; 147: 175-280.
14. Vogel SB, Howard RJ, Carid J, Howkins IF Evaluation of percutaneous transhepatic balloon dilatation of benign biliary strictures in high-risk patients. Am J Surg 1985; 149: 73-9.
15. Andren-Sandberg A, Johansson S, Bengmark S Accidental lesions of the common bile duct at cholecystectomy: II. results of treatment. Ann Surg 1985; 201: 452-5.
16. Csendes A, Thompson JN, Soreide, et al Late results of immediate primary end to end repair in accidental section of the common bile duct Surg Gynecol Obstet 1989; 168: 125-30.
17. Pappalardo G, Cornetti S, Mobarhan S, et al Long-term results of Roux-en Y hepaticojejunostomy and hepaticojejunoduodenostomy Ann Sung 1982; 196: 149-52.

Thank you for copying data from http://www.arastirmax.com