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Cirugía paraguaya

On-line version ISSN 2307-0420

Abstract

RAMIREZ-SOTOMAYOR, Julio; ADORNO, Carlos  and  RODRIGUEZ-VERA, Ramón. EXPERIENCE IN THE MANAGEMENT OF SURGICAL LESIONS BILIARY. Rev. Cir. Parag. [online]. 2016, vol.40, n.1, pp.8-12. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.2016.mayo.8-12.

Introduction:

Surgical lesions of the bile ducts (LQVB) are defined as the arrest of bile flow by ligation, clipping or scar stenosis, partial or complete bile duct or bile ducts abhorrent section. Objective: To describe the experience in the management of the surgical lesion of the bile in the surgery service of the National Hospital of Itauguá.

Patients and methods:

study retrospective, descriptive, observational transverse cut, they were included patients with surgical bile duct injury treated in General Surgery from the National Hospital of Itauguá service between March 2010 until November 2015.

Results:

Of the 29 cases of injury biliary tract, 25 cases were female and 4 male. The average age was 43 years, with a minimum of 17 and maximum of 74 years. 21 lesions were referred from other hospitals. 14 cases during elective surgery, 21 conventional route and 8 laparoscopically. The intraoperative diagnosis was in 10 cases. In 14 cases the lesions were complex (greater than 50% of the light or associated with vascular injury) where repair in these patients was the jejunum Hepático bypass anastomosis Roux-Y Hepp-Couinaud type. Mortality was 1 case (3.4%).

Conclusions:

1. Find a predominance of cases in females, 86.2%. 2. 27.6% lesion was produced in our service. 3. The diagnosis of the lesion was performed in the post-op 65.5% of the cases. 4. Of the 29 cases, only 27.5% of patients with a diagnosis of LQVB, were operated by laparoscopic approach. 5. In 48.2% of the cases were found complex lesions including: affectation = 50% of light, next to the Carrefour and/ or associated vascular lesions. 6. The liver jejunum Anastomosis with Hepp-Couinaud technique is the technique most used by our service in the reconstruction of biliary tract by LQVB, with acceptable results in terms of post-operative morbidity and stenosis.

Keywords : Biliary tract surgical injury; Roux-Y anastomosis.

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