Abstract

GONZALEZ GONZALEZ, José Luis et al. Reconstruction of 183 iatrogenic lesions in the bile duct . Rev Cubana Cir [online]. 2012, vol.51, n.4, pp. 288-306. ISSN 0034-7493.

Introduction: iatrogenic lesions in the bile duct are one of the main concerns for general surgeons. As it was expected, with the onset of the so-called laparoscopic era, increased incidence of these lesions was noticed after the introduction of a new technique. However, this increase, which even duplicated the amount of lesions occurred in the open surgery, has remained the same further than what might be expected from a learning curve. The objective of this paper was to evaluate the behavior and the result of the applied surgical treatment. Methods: across-sectional descriptive study was performed on 183 patients diagnosed with iatrogenic lesion in the main bile duct, who had been treated at “Hermanos Ameijeiras” hospital from May 1983 to December 2008. Results: the incidence of bile duct lesions in our center was 0.14 %. Females prevailed in the series, with average age of 44.7 years. The conventional surgical treatment caused more lesions, accounting for 55.2 %; the majority of them were diagnosed in the postoperative period where lesions located less than 2cm away from the hepatic confluent. The most frequent surgical modality was Roux's Y-form hepaticojejunostomy. External biliary fistula and surgical wound infection were the main postoperative complications. Conclusions: the correlation among variables and the results of the treatment showed that both the use of external drainage and the type 5 lesions are predictors of postoperative morbidity and mortality.

Keywords : iatrogenia; bile duct; hepaticojejunostomy.

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