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>Revistas >Cirujano General >Año 2015, No. 3-4


Bonifaz CJE, Palacio VAF
Reconstrucción de la vía biliar, secundaria a lesiones mayores iatrogénicas
Cir Gen 2015; 37 (3-4)

Idioma: Español
Referencias bibliográficas: 52
Paginas: 70-81
Archivo PDF: 303.40 Kb.


Texto completo


RESUMEN

Antecedentes: La lesión de vía biliar es una de las complicaciones más temidas, peligrosas y que aumentan la morbimortalidad. Con la colecistectomía laparoscópica se incrementó la incidencia de lesión hasta que se estabilizó en un 1.3%, lo cual es aún alto para el 0.6% de la era abierta. El objetivo es mostrar la experiencia de la unidad hospitalaria en el manejo de la lesión de vía biliar en un periodo de 30 años. Material y métodos: Éste es un estudio retrospectivo, descriptivo, observacional en pacientes del Servicio de Cirugía General del Hospital Regional “General Ignacio Zaragoza” en el periodo comprendido de 1980 a 2009, con análisis de expedientes clínicos, estudios de laboratorio e imágenes de control y seguimiento de los pacientes intervenidos quirúrgicamente. Se incluyeron, solamente, individuos con lesiones mayores de vía biliar con diagnóstico trans- y postoperatorio sometidos a reconstrucción de la misma. Se intervinieron 67 sujetos, de los cuales 58 eran mujeres y nueve hombres. Resultados: El tipo de lesión más frecuente fue Bismuth III y el procedimiento quirúrgico más utilizado fue la hepaticoyeyunoanastomosis en Y de Roux, en 54 de ellos, con un 5.2% de mortalidad en los primeros 13 meses y un 89.5% de éxito en el primer año de seguimiento. Conclusiones: La incidencia de la lesión de la vía biliar durante un procedimiento quirúrgico es baja en centros de concentración y alta especialidad. Es imperativo para el cirujano conocer las alternativas diagnósticas y quirúrgicas al enfrentar este tipo de lesiones.


Palabras clave: Colédoco, lesión, reconstrucción, vía biliar.


REFERENCIAS

  2. Bachellier P, Nakano H, Weber JC, et al. Surgical repair after bile duct and vascular injuries during laparoscopic cholecystectomy: when and how? World J Surg. 2001; 25: 1335-1345.

  3. Tsalis K, Zacharakis E, Sapidis N, et al. Complications during and after laparoscopic cholecystectomy. An audit of 1042 cases. HPB (Oxford). 2005; 7 Suppl 1: 133.

  4. De Reuver PR, Busch ORC, Rauws EA, et al. Long-term results of a primary end-to-end anastomosis in peroperative detected bile duct injury. J Gastrointest Surg. 2007; 11: 296-302.

  5. Moossa AR, Easter DW, van Sonnenberg E, et al. Laparoscopic injuries to the bile duct. A cause for concern. Ann Surg.1992; 215: 203-208.

  6. Bergman JJ, van den Brink GR, Rauws EA, et al. Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut. 1996; 38: 141-147.

  7. Richardson MC, Bell G, Fullarton GM. Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. Br J Surg. 1996; 83: 1360-1365.

  8. Nuzzo G, Giuliante F, Giovannini I, et al. Bile duct injury during laparoscopic cholecystectomy: results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005; 140: 986-992.

  9. Gouma DJ, Obertop H. Management of bile duct injuries: treatment and long-term results. Dig Surg. 2002; 19: 117-122.

  10. Krahenbühl L, Sclabas G, Wente MN, et al. Incidence, risk factors, and prevention of biliary tract injuries during laparoscopic cholecystectomy in Switzerland. World J Surg. 2001; 25: 1325-1330.

  11. Walsh RM, Vogt DP, Ponsky JL, et al. Management of failed biliary repairs for major bile duct injuries after laparoscopic cholecystectomy. J Am Coll Surg. 2004; 199: 192-197.

  12. Bruce E, Stabile MD. Laparoscopic cholecystectomy associated bile duct injuries. WJM. 1998; 168: 41.

  13. Johnston GW. Iatrogenic bile duct stricture: an avoidable surgical hazard? Br J Surg. 1986; 73: 245-247.

  14. Smith EB. Iatrogenic injuries to extra hepatic ducts and associated vessels: a twenty-five year analysis. J Natl Med Assoc. 1982; 74: 735-738.

  15. Keulemans YC, Bergman JJ, de Wit LT, et al. Improvement in the management of bile duct injuries? J Am Coll Surg. 1998; 187: 246-254.

  16. Buell JF, Cronin DC, Funaki B, et al. Devastating and fatal complications associated with combined vascular and bile duct injuries during cholecystectomy. Arch Surg. 2002; 137: 703-710.

  17. Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg. 2003; 237: 460-469.

  18. Bektas H, Schrem H, Winny M, et al. Surgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems. Br J Surg. 2007; 94: 1119-1127.

  19. Neuhaus P, Schmidt SC, Hintze RE, et al. Classification treatment of bile duct injuries after laparoscopic cholecystectomy. Chirurg. 2000; 71: 166-173.

  20. Siewert JR, Ungeheuer A, Feussner H. Bile duct lesions in laparoscopic cholecystectomy. Chirurg. 1994; 65: 748-757.

  21. Alves A, Farges O, Nicolet J, et al. Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct strictures. Ann Surg. 2003; 238: 93-96.

  22. De Santibáñes E, Ardiles V, Pekolj J. Complex bile duct injuries: management. HPB (Oxford). 2008; 10: 4-12.

  23. Babel N, Sakpal SV, Paragi P, et al. Iatrogenic bile duct injury associated with anomalies of the right hepatic sectoral ducts: a misunderstood and underappreciated problem. HPB Surg. 2009; 2009: 153269.

  24. Colovic RB. Isolated segmental, sectoral and right hepatic bile duct injuries. World J Gastroenterol. 2009; 15: 1415-1419.

  25. Fragulidis G, Marinis A, Polydorou A, et al. Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: an algorithmic approach. World J Gastroenterol. 2008; 14: 3049-3053.

  26. Ayuso JR, Ayuso C, Bombuy E, et al. Preoperative evaluation of biliary anatomy in adult live liver donors with volumetric mangafodipir trisodium enhanced magnetic resonance cholangiography. Liver Transpl. 2004; 10: 1391-1397.

  27. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995; 180: 101-125.

  28. Archer SB, Brown DW, Smith CD, et al. Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Ann Surg. 2001; 234: 549-559.

  29. Tay KH. Laparoscopic cholecystectomy: an audit of our training programme in Singapore. HPB (Oxford). 2005; 7 Suppl 1: 136.

  30. Smith EB. Complications of laparoscopic cholecystectomy. J Natl Med Assoc. 1992; 84: 880-882.

  31. De Reuver PR, Grossmann I, Busch OR, et al. Referral pattern and timing of repair are risk factors for complications after reconstructive surgery for bile duct injury. Ann Surg. 2007; 245: 763-770.

  32. Sicklick JK, Camp MS, Lillemoe KD, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg. 2005; 241: 786-792; discussion 793-795.

  33. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001; 25: 1241-1244.

  34. Chaudhary A, Chandra A, Negi SS, et al. Reoperative surgery for postcholecystectomy bile duct injuries. Dig Surg. 2002; 19: 22-27.

  35. Jablonska B, Lampe P. Iatrogenic bile duct injuries: etiology, diagnosis and management. World J Gastroenterol. 2009; 15: 4097-4104.

  36. Tocchi A, Mazzoni G, Liotta G, et al. Late development of bile duct cancer in patients who had biliary-enteric drainage for benign disease: a follow-up study of more than 1,000 patients. Ann Surg. 2001; 234: 210-214.

  37. Fischer CP, Fahy BN, Aloia TA, et al. Timing of referral impacts surgical outcomes in patients undergoing repair of bile duct injuries. HPB (Oxford). 2009; 11: 32-37.

  38. Lillemoe KD, Melton GB, Cameron JL, et al. Postoperative bile duct strictures: management and outcomes in the 1990s. Ann Surg. 2000; 232: 430-441.

  39. Lillemoe KD, Martin SA, Cameron JL, et al. Major bile duct injuries during laparoscopic cholecystectomy. Follow-up after combined surgical and radiologic management. Ann Surg. 1997; 225: 459-471.

  40. Mercado MA, Chan C, Orozco H, et al. To stent or not to stent bilioenteric anastomosis after iatrogenic injury: a dilemma not answered? Arch Surg. 2002; 137: 60-63.

  41. Hall JG, Pappas TN. Current management of biliary strictures. J Gastrointest Surg. 2004; 8: 1098-1110.

  42. Ahrendt SA, Pitt HA. Surgical therapy of iatrogenic lesions of biliary tract. World J Surg. 2001; 25: 1360-1365.

  43. Johnson SR, Koehler A, Pennington LK, et al. Long-term results of surgical repair of bile duct injuries following laparoscopic cholecystectomy. Surgery. 2000; 128: 668-677.

  44. Tocchi 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: 162-167.

  45. Terblanche J, Worthley CS, Spence RA, et al. High or low hepaticojejunostomy for bile duct strictures? Surgery. 1990; 108: 828-834.

  46. Boerma D, Rauws EA, Keulemans YC, et al. Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis. Ann Surg. 2001; 234: 750-757.

  47. De Reuver PR, Sprangers MA, Gouma DJ. Quality of life in bile duct injury patients. Ann Surg. 2007; 246 :161-163.

  48. Andersson R, Eriksson K, Blind PJ, et al. Iatrogenic bile duct injury —a cost analysis. HPB (Oxford). 2008; 10: 416-419.

  49. Savader SJ, Lillemoe KD, Prescott CA, et al. Laparoscopic cholecystectomy-related bile duct injuries: a health and financial disaster. Ann Surg. 1997; 225: 268-273.

  50. Chow SC, Sahajpal AK, Dixon E, et al. Bile duct injuries associated with laparoscopic cholecystectomy: timing of repair determines long-term outcomes. Can J Surg. 2008; 51 Suppl: 42.

  51. Silva MA, Coldham C, Mayer AD, et al. Specialist outreach service for on-table repair of iatrogenic bile duct injuries —a new kind of “travelling surgeon”. Ann R Coll Surg Engl. 2008; 90: 243-246.

  52. Pekolj J. Manejo de las complicaciones más frecuentes de la cirugía abdominal. Rev Arg Cirg. 2003 [Número extraordinario].

  53. De Santibañés E, Sivori J, Pekolj J, et al. Lesiones de la vía biliar secundaria a colecistectomía laparoscópica. Rev Arg Cirg. 1996; 70: 208-219.



>Revistas >Cirujano General >Año2015, No. 3-4
 

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