Díaz-Martínez Jair, Chapa-Azuela Oscar, Roldan-García Jorge Alberto, Flores-Rangel Gustavo Alain
Hepato Pancreato Biliary Clinic, Hospital General de Mexico, Mexico City, Mexico.
Ann Hepatobiliary Pancreat Surg. 2020 May 31;24(2):150-155. doi: 10.14701/ahbps.2020.24.2.150.
BACKGROUNDS/AIMS: The bile duct injuries are the most severe complications that occur after the surgical manipulation of the bile duct. The hepaticojejunostomy remained as the best treatment. Several factors identified that affect the result. This study aimed to analyze and identify risk factors that affected the evolution of these patients.
A retrospective, observational study was conducted from February 1998 to June 2017. We included all patients with bile duct injuries who required surgical treatment.
We found 79 patients. The majority had a Bismuth type III in 35.4% (n=28). The morbidity of the Hepaticojejunostomy was 19% (n=15). In short-term follow-up, the main complications were cholangitis 11.4% (n=9) and bile leak 10% (n=8). In the long-term follow-up, in 2.5% (n=2) stricture was presented. On the comparison between postoperative and preoperative parameters, biliary peritonitis after a cholecystectomy (=0.02) was an independent predictor of postoperative morbidity (<0.05).
In the treatment of bile duct injuries, different factors affect their outcomes. Our results show that infectious complications continue to affect the results of the treatment of bile duct lesions.
背景/目的：胆管损伤是胆管手术操作后发生的最严重并发症。肝空肠吻合术仍然是最佳治疗方法。已确定了几个影响治疗结果的因素。本研究旨在分析和确定影响这些患者病情发展的危险因素。
进行了一项回顾性观察研究，时间跨度为1998年2月至2017年6月。我们纳入了所有需要手术治疗的胆管损伤患者。
我们共找到79例患者。大多数患者为Bismuth III型，占35.4%（n = 28）。肝空肠吻合术的发病率为19%（n = 15）。在短期随访中，主要并发症为胆管炎，占11.4%（n = 9），胆漏占10%（n = 8）。在长期随访中，出现狭窄的占2.（n = 2）。在比较术后和术前参数时，胆囊切除术后的胆汁性腹膜炎（P = 0.02）是术后发病率的独立预测因素（P < 0.05）。
在胆管损伤的治疗中，不同因素会影响其治疗结果。我们的结果表明，感染性并发症继续影响胆管损伤的治疗结果。
