Department of Surgery and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Argentina.
HPB (Oxford). 2008;10(1):4-12. doi: 10.1080/13651820701883114.
Laparoscopic cholecystectomy is the present treatment of choice for patients with gallbladder stones, despite its being associated with a higher incidence of biliary injuries compared with the open procedure. Injuries occurring during the laparoscopic approach seem to be more complex. A complex biliary injury is a disease that is difficult to diagnose and treat. We considered complex injuries: 1) injuries that involve the confluence; 2) injuries in which repair attempts have failed; 3) any bile duct injury associated with a vascular injury; 4) or any biliary injury in association with portal hypertension or secondary biliary cirrhosis. The present review is an evaluation of our experience in the treatment of these complex biliary injuries and an analysis of the international literature on the management of patients.
腹腔镜胆囊切除术是目前治疗胆囊结石的首选方法，尽管与开放手术相比，其胆道损伤的发生率更高。腹腔镜手术中发生的损伤似乎更为复杂。复杂的胆道损伤是一种难以诊断和治疗的疾病。我们将复杂损伤定义为：1）涉及汇合处的损伤；2）修复尝试失败的损伤；3）任何伴有血管损伤的胆管损伤；4）或任何伴有门静脉高压或继发性胆汁性肝硬化的胆管损伤。本综述评估了我们治疗这些复杂胆道损伤的经验，并对国际上关于这些患者处理的文献进行了分析。
