Method of reconstructive surgery for damaged extrahepatic bile ducts: immediate and long-term results

A. B. Sidorenko, Y. I. Zakharov, Y. Moysyuk
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Abstract

Background. Reconstructive surgery for iatrogenic injuries of the bile ducts involves the formation of a biliodigestive anastomosis. The development of anastomotic stricture is the most severe complication of this operation.Aim of the study. To evaluate the immediate and long-term results of treatment and follow-up of patients with iatrogenic injuries of the bile ducts who underwent reconstructive surgery on the bile ducts with additional creation of gastroenteroanastomosis.Material and methods. The study included 26 patients operated on according to the original method in the period 2010-2018.Results. In the study group, complications in the early postoperative period developed in 3 (11.5%) patients. Endoscopic interventions using the formed gastroenteroanastomosis in the long-term period were performed in 7 patients. The results of treatment were followed in 25 (96%) patients. The median follow-up period was 90 months [81.5;110] (42-129). Conclusion. The use of the proposed original technique of reconstructive surgery has demonstrated its effectiveness and safety, with the possibility of dynamic endoscopic control and, if necessary, the treatment of postoperative complications such as cholelithiasis and biliodigestive anastomosis strictures.
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肝外胆管损伤的重建手术方法:近期和远期效果
背景。医源性胆管损伤的重建手术包括形成胆管-消化吻合术。吻合口狭窄的发展是该手术最严重的并发症。研究的目的。目的评价医源性胆管损伤患者行胆管重建手术加胃肠吻合术的近期和长期治疗及随访效果。材料和方法。本研究纳入了2010-2018年按原方法手术的26例患者。研究组术后早期出现并发症3例(11.5%)。7例患者采用形成的胃肠吻合口进行长期内镜干预。25例(96%)患者随访治疗结果。中位随访期为90个月[81.5;110](42-129)。结论。采用拟议的原始重建手术技术已证明其有效性和安全性,具有动态内镜控制的可能性,必要时可治疗术后并发症,如胆石症和胆道消化吻合口狭窄。
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