«SMALL» INJURIES OF BILIARY DUCTS. DIAGNOSIS AND MINIINVASIVE METHODS OF CORRECTION
Introduction. Experience of the bile leakage treatment as a consequence of the biliary ducts «small» injuries in laparoscopic cholecystectomy (LCHE) was accomplished. Advantages of miniinvasive technologies, comparing with open surgical interventions, are discussed.
Маterials and methods. In 2001 - 2015 yrs 45 patients, suffering bile leakage as a consequence of the biliary ducts «small» injuries, were treated. In the main group miniinvasive technologies were applied, and in the comparison group – оpen surgical procedures.
Results. In the main group miniinvasive technologies were applied twice as more while with the comparison group.
Conclusion. Мiniinvasive procedures, including, relaparoscopy, retrograde transpapillary interventions, transcutaneous draining permit to achieve better results, they must constitute a priority for the patients, suffering biliary leakage after LCHE.
Кeywords: laparoscopic cholecystectomy; «small» injury of biliary ducts; miniinvasive technologies.
2. Nordin A, Grönroos JM, Mäkisalo H. Treatment of biliary complications after laparoscopic cholecystectomy. Scand J Surgery. 2011;(100):42-8. DOI: 10.1177/145749691110000108.
3. Lau WY, Lai EC. Classification of iatrogenic bile duct injury. Hepatobiliary Pancreat Dis Int. 2007;6(5):459-63.
4. Kook KH, Kim TN. Endoscopic management of bile leakage after cholecystectomy: a single-center experience for 12 years. Clin Endos. 2014;47(3):248 - 53. DOI: 10.5946/ce.2014.47.3.248
5. Paajanen H, Suuronen S, Eskelinen M, Hytonen S, Juvonen P. Frequency of bile leak after laparoscopic cholecystectomy: audit of a surgical residency program. American Surgeon. 2014;80(1):91-4.
6. Barkun AN, Rezieg M, Mehta SN, Pavone E, Landry S, Barkun JS et al. Postcholecystectomy biliary leaks in the laparoscopic era: risk factors, presentation, and management. Mc Gill Gallstone Treatment Group. Gastrointest Endosc. 1997;45(3):277-82.
7. Sinhaand R, ChandraS. Cystic duct leaks after laparo endoscopic single-site cholecystectomy. J Laparo Endosc Adv Surg Tech A. 2012;22(6):533-7.
8. Lo Nigro C, Geraci G, Sciuto A, Li Volsi F, Sciume C, Modica G. Bile leaks after videolaparoscopic cholecystectomy: duct of Luschka. Endoscopic treatment in a single centre and brief literature review on current management. Ann Ital Chir. 2012;83(4):303-12.
9. Pacahuala-DelCarmenand MA, Enriquez-Adalid M.R. Conservative treatment of the bile leak after of laparoscopic cholecystectomy. Rev Med Inst Mex SeguroSoc. 2011;49(3):301-6.
10. Chinnery GE, Krige JE, Bornman PC, Bernon MM, Al-Harethi S, Hofmeyr S, et al. Endoscopic management of bile leaks after laparoscopic cholecystectomy. S Afr J Surg. 2013;51(4):116-21. doi: 10.7196/sajs.1829.