Year 2019 / Volume 111 / Number 9
Submission and tracking of manuscripts
Instructions to authors

Submission and tracking

SED 2019

SED 2019

Spanish Week of Digestive Diseases 2019

More Information

REED Journal

REED Journal

Play video

Year 2019 / Volume 111 / Number 9

Original

The role of endoscopic retrograde cholangiopancreatography in the management of iatrogenic bile duct injury after cholecystectomy

690-695

Marina Garcés-Albir, Rosa Martí-Fernández, Guillermo Martínez-Fernández, Andrés Peña-Aldea, Elena Muñoz-Forner, Vicente Sanchiz-Soler, Dimitri Dorcaratto, Consuelo Gálvez-Castillo, José Martín-Arévalo, Luis Sabater, Joaquín Ortega,

Introduction: iatrogenic bile duct injury (IBDI) is a complication with a high morbidity after cholecystectomy. In recent years, endoscopy has acquired a fundamental role in the management of this pathology. Methods: a retrospective study of IBDI after open cholecystectomy (OC) or laparoscopic cholecystectomy (LC) of patients treated in our center between 1993 and 2017 was performed. Clinical characteristics, type of injury according to the Strasberg-Bismuth classification, diagnosis, repair techniques and follow-up were analyzed. Results: 46 patients were studied and IBDI incidence was 0.48%, 0.61% for LC and 0.24% for OC. A diagnosis was made intraoperatively in 12 cases (26%) and by endoscopic retrograde cholangiopancreatography (ERCP) in 10 (21.7%) cases. The most common IBDI patient characteristics were acute cholecystitis (20/46, 43.5%), previous admission due to biliary pathology (16/46, 43.2%) and ERCP prior to cholecystectomy (7/46, 18.9%). The most frequent types of IBDI were D (17/46, 36.9%) and A (15/46, 32.6%). The most commonly used treatment was primary suture (13/46, 28.3%) followed by ERCP (11/46, 23.9%) with sphincterotomy and/or stents. In addition, ERCP was performed during the immediate postoperative period in 6 (13%) patients with a surgical IBDI repair in order to resolve immediate complications. Conclusion: ERCP is useful in the management of IBDI that is not diagnosed intraoperatively. This procedure facilitates the localization of the injured area of the bile duct, therapeutic maneuvers and successful outcomes in postoperative complications.

Valoración del lector: Valora este artículo:
Share Button
Send by e-mail

New comment


Security code:
CAPTCHA code image
Speak the codeChange the code
 

Comments

No hay comentarios para este artículo.
Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2019 The Spanish Journal of Gastroenterology