• Hepato Gastroenterol · Dec 2007

    Hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy. A retrospective study on 51 cases.

    • Giovanni Conzo, Giuseppe Amato, Luigi Angrisani, Ugo Bardi, Giulio Belli, Umberto Brancaccio, Fulvio Calise, Salvatore Celsi, Francesco Corcione, Diego Cuccurullo, Giuseppe De Falco, Carlo De Werra, Guido De Sena, Giovanni Docimo, Maria Grazia Esposito, Corrado Fantini, Cristiano Giardiello, Antonio Livrea, Michele Lorenzo, Carlo Molino, Mario Musella, Crescenzo Muto, Antonietta Palazzo, Alberto Porcelli, Roberto Rea, Franco Rendano, Michele Santangelo, Walter Santaniello, Luigi Santini, Pasquale Sperlongano, Francesco Stanzione, Alberto Tartaglia, Annunziato Tricarico, Rodolfo Vincenti, and Paolo Delrio.
    • LAP Club, Gruppo Collaborativo per lo Studio Della Chirurgia Videolaparoscopica Città della Scienza, Napoli, Italy. giovanni.conzo@unina2.it
    • Hepato Gastroenterol. 2007 Dec 1; 54 (80): 2328-32.

    Background/AimsLaparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003.MethodologyThe Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed.ResultsThe mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while in 4/51 (7.84%) a biliary stent was positioned. In 1/51 patients (1.9%) a biliary cirrhosis and in 3/51 (5.7%) a bioumoral cholestasis was observed.ConclusionsLaparoscopic cholecystectomy causes a higher incidence of iatrogenic biliary lesions. Hepaticojejunostomy gives better long-term results and lower morbidity compared to T-Tube plasty. Management of septic complications in patients with iatrogenic biliary lesions represents the first therapeutic step.

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