Zerrweck LC, Ortiz de la PRJ, Orozco OP, Sánchez JGO, Golffier RC, Hernández VFX

Language: Spanish
References: 12
Page: 86-89
PDF size: 142.76 Kb.

ABSTRACT

Background: Laparoscopic cholecystectomy is now considered the gold standard in the treatment of cholelithiasis, finding an increased rate of bile duct injury, when compared with the open approach. The management of these benign injuries becomes complex and specialized, originally done only by surgery. This approach has change in the last decades since the coming of interventional endoscopy and radiology, in which bile duct stents are used. The decision of using a non surgical treatment is mainly based on the patients characteristics, the hospital´s resources and the medical skills of the doctors involved. Clinical case: A 63 years old female, with history of bile duct injury treated with surgery, who continued with episodes of cholangitis despitc several other treatments. A percutaneous self-expanding metallic bile duct stent was used, and 35 months later it migrated, causing intestinal obstruction. Conclusions: Management of bile duct injuries can be done in several ways, depending the type of injury, patient´s characteristics and medical resources. The interventional endoscopy and radiology treatment offer the same results than biledigestive surgery in selected patients. The use of self-expanding metallic stents in patients with bile duct injury and previous biledigestive surgery has not been studied, so is difficult to determine their patency rate, therefore should be used in exceptional cases. Physicians should be aware of the possible complications to act fast in an emergency.

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