Causes of Reintervention of Biliary-Digestive Derivation at UMAE HE 71 from 2015 to 2020
Main Article Content
Abstract
Objective: Describe the causes of biliodigestive bypass reoperation in our center.
Material and methods. Retrospective, descriptive and observational study.
Results. A total of 64 records were reviewed. 53.1% of the patients underwent reintervention after biliodigestive bypass surgery, in some cases on more than one occasion to the same patient, thus making a total of 61 biliodigestive bypass reintervention surgeries. in unity. The most frequent causes for reintervention were stenosis with a frequency of 70.4%, lithiasis 22.9%, anastomotic dehiscence 4.9% and bilioma 1.6%. In patients who had a diagnosis of stenosis in their first reoperation, it was associated with subsequent reinterventions being for the same diagnosis, with a value of p = 0.087.
Conclusions. Any attempt at bile duct repair by inexperienced surgeons or in non-specialized centers should be avoided, in addition to early referral of patients. Avoid instrumentation before bile duct reconstruction due to its possible complications. The surgical technique of hepaticojejunostomy is essential for reducing postoperative complications and better long-term results.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. De Santibanes E, Ardiles V. Complex bile duct injuries: management. HPB Oxford 2008; 10 (1): 4-12
II. Yang YL, Zhang C, Zhang HW, Wu P, Ma YF, Lin MJ, et. al. Common bile duct injury by fibrin glue: Report of a rare complication. World J Gastroenterol. 2015; 21:2854-2857
III. Dong J, Feng X, Duan W. Steping into the segment era of biliary surgery. Chinese Journal of Digestive Surgery. 2017; 16:341-344.
IV. Mercado MA et al. Lesión iatrógena de la vía biliar. Experiencia en la reconstrucciónen180 pacientes. RevGastroenterolMex. 2002;67(4):245- 249.
V. Kadaba RS et al.Complications of biliary-enteric anastomoses. Ann R Coll Surg Engl. 2017; 99 (3) :210-215.
VI. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180(1):101–125.
VII. Flores K, Lope M. Derivaciones biliodigestivas y el manejo de sus complicaciones, realizadas a los pacientes con patologías biliares atendidos en el servicio de Cirugía del Hospital Alemán Nicaragüense de Enero 2013 a Noviembre del 2015. (tesis monográfica, para obtener el grado de especialista en Cirugía General en internet) En la UNIVERSIDAD NACIONAL AUTOMONA DE NICARAGUA 2016 (Citado el 20 de enero del 2023) recuperado a partir de: https://repositorio.unan.edu.ni/726/1/72211.pdf.
VIII. De Santibanes E, Ardiles V. Complex bile duct injuries: management. HPB Oxford 2008; 10 (1): 4-12
IX. Murr MM, Gigot JF, Nagorney DM, Harmsen WS, Ilstrup DM, Farnell MB; Long-term results of biliary reconstruction after laparoscopic bile duct injuries: Arch Surg, 1995; 134:604-10
X. AbdelRafee A, El-Shobari M, Askar W, Sultan A,El Nakeeb A; Long-Term Follow-up of 120 Patients after Hepaticojeju-nostomy for Treatment of Post- Cholecystectomy Bile Duct Injuries.; International J Surg, 2015; 18.205-210
XI. Sicklick J et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy. Ann Surg. 2005; 241 (5): 786-795
XII. Stewart L. Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 2014;94(2):297–310
XIII. Hart RS, Passi RB, Wall WJ. Long-term outcome after repair of major bile duct injury created during laparoscopic cholecystectomy. HPB 2000; 2 (3): 325-332.
XIV. Tocci A. Costa G, Lepre L, et al. The long-term outcome of hepaticojejunostomy in the treatment of benign bile duct strictures. Ann Surg.1996; 224 (2): 162.