Velasco-Espinoza MF, Salinas-Cruz JA, Rodarte-Reveles A, Bernal-Llamas AK, Ron-Padilla C

Language: Spanish
References: 14
Page: 159-163
PDF size: 214.57 Kb.

ABSTRACT

Aim: To determine the prevalence of biliary tract injury after laparoscopic or open cholecystectomy at the Hospital General 450 in Durango, Mexico, and compare it with the national prevalence. Material and methods: A descriptive and retrospective analysis of the clinical charts at the hospital’s General Surgery Unit was conducted and included patients with the diagnosis of biliary tract injury that had been hospitalized between June 2014 and December 2016. The study variables were the prevalence of biliary tract injury (according to the Strasberg’s classification), age and gender. Results: In two years and six months, 855 cholecystectomies were performed in patients of both sexes between the ages of 21 and 75; 341 cholecystectomies were laparoscopic and 514 were conventional. A total of 11 biliary tract injuries were reported, 10 were repaired by biliodigestive bypass (Roux-en-Y hepaticojejunal anastomosis) and one by terminoterminal anastomosis of the common bile duct and placement of a T-tube. Three deaths were reported, yielding a mortality rate of 27%. Conclusions: At the Hospital General 450, the frequency of biliary tract injury is 0.87% after laparoscopic cholecystectomy and 0.58% after open cholecystectomy. This is in contrast with the results obtained in studies on central and southern Mexico by Gutiérrez et al., in South America by Hoyos and his group, and in the U.S.A. by Chuang et al. we conclude that the prevalence of biliary tract injury at this hospital is high, perhaps due to factors such as patient body mass index and the duration of symptoms from the condition appearance until surgical resolution, which have been identified as important causes of surgical complications.

REFERENCES

1. Nuzzo G, Giuliante F, Giovannini I, Murazio M, D’Acapito F, Ardito F, et al. Advantages of multidisciplinary management of bile duct injuries occurring during cholecystectomy. Am J Surg. 2008; 195: 763-769.

2. Gigot JF. Bile duct injury during laparoscopic cholecystectomy: risk factors, mechanisms, type, severity and immediate detection. Acta Chir Belg. 2003; 103: 154-160.

3. Ruiz GF, Ramia AJ, García PJ, Figueras J. Lesiones iatrogénicas de la vía biliar. Cir Esp. 2010; 88: 211-221.

4. Hoyos SI, Quintero VM. Lesión quirúrgica de la vía biliar: experiencia en la unidad de cirugía hepatobiliar y pancreática, del hospital Pablo Tobón Uribe de Medellín. Rev Colomb Cir. 2009; 24: 244-249.

5. Losada MH, Muñoz CC, Burgos SL, Silva AJ. Reconstrucción de lesiones de la vía biliar principal. La evolución hacia la técnica Hepp-Couinaud. Rev Chil Cir. 2011; 63: 48-53.

6. Mercado MA, Domínguez I. Classification ad management of bile injuries. World J Gastrointest Surg. 2011; 3: 43-48.

7. Chuang KI, Corley D, Postlethwaite DA, Merchant M, Harris HW. Does increased experience with laparoscopic cholecystectomy yield more complex bile duct injuries? Am J Surg. 2012; 203: 480-487.

8. Baron TH, Grimm IS, Swanstrom LL. Interventional approaches to gallbladder disease. N Engl J Med. 2015; 373: 357-365.

9. Gutiérrez PJ, Medina GP, Ortiz RS, Lozano CH. Lesiones de la vía biliar: prevalencia en pacientes con colecistectomía laparoscópica en un hospital de especialidades. Cir Gen. 2011; 33: 38-42.

10. Pérez MA, Morales GM, Huerta JM, Röesch DF. Resultados del tratamiento quirúrgico de la iatrogenia de las vías biliares. Experiencia de 25 años. Cir Gen. 2005; 27: 52-56.

11. Asociación Mexicana de Cirugía General AC, Comité de Elaboración de Guías de Práctica Clínica. Guía de práctica clínica para lesión benigna de vías biliares. Ciudad de México; 2014.

12. ENdSyNRN. Encuesta Nacional de Salud y Nutrición. Resultados Nacionales 2012. 2012.

13. Mercado MA, Urencio MJ, Franssen CB, Ramírez DVF, Elnecavé OA. El índice de masa corporal como factor de riesgo para complicaciones posteriores a una derivación biliodigestiva por lesión benigna de la vía biliar. Cir Gen. 2010; 32: 149-154.

14. Mercado MA. Lesión iatrogénica de la vía biliar. Experiencia en la reconstrucción en 180 pacientes. Revista de Gastroenterología México. 2002; 67: 236-284.