SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS
The results of examination and treatment were analyzed in 51 patients with iatrogenic injuries of the bile-excreting ducts. Patients were divided into 5 groups according to international classification (EAES, 2013). It depended on the time of detection, the nature and scale of damage of the bile duc...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | Russian |
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Pavlov First Saint Petersburg State Medical University
2015-10-01
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| Series: | Вестник хирургии имени И.И. Грекова |
| Subjects: | |
| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/112 |
| _version_ | 1797877790958157824 |
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| author | N. A. Maistrenko P. N. Romashchenko A. S. Pryadko A. K. Aliev |
| author_facet | N. A. Maistrenko P. N. Romashchenko A. S. Pryadko A. K. Aliev |
| author_sort | N. A. Maistrenko |
| collection | DOAJ |
| description | The results of examination and treatment were analyzed in 51 patients with iatrogenic injuries of the bile-excreting ducts. Patients were divided into 5 groups according to international classification (EAES, 2013). It depended on the time of detection, the nature and scale of damage of the bile ducts, mechanism of injury, development of infectious and septic complications. Injuries of the main bile duct were detected intraoperatively (n=14). The complete intersection was in 10 patients (the first group) and the edge intersection - in 4 cases (the second group). Iatrogenic injuries of the bile-excreting ducts were revealed in 37 patients in postoperative period. There were the complete intersections in 28 cases (the third group) and the edge intersections - in 7 cases (the fifth group). Injuries of additional bile ducts were determined in 2 patients (the fifth group). An analysis of the main qualifying features of iatrogenic injuries of the bile-excreting ducts allowed defining indications to reconstructive-restorative surgery in 60,8% patients, restorative operations - in 29,4%, an external drainage - in 5,8% and reclipping of additional bile ducts in relaparoscopy - in 3,9%. The rational surgical approach allowed obtaining perfect results in 65,8% and good, satisfactory results in immediate and long-term period with low postoperative lethality of 1,95%. The study of diagnostics results and treatment of the patients with iatrogenic injuries of the bile-excreting ducts indicated about reasonability of assessment of main factors, which are based on iatrogenic injuries according to the EAES classification. An individual program of examination and more rational variant of surgery could be chosen due to this approach, which provides minimization of negative results and good quality of life. |
| first_indexed | 2024-04-10T02:23:29Z |
| format | Article |
| id | doaj.art-34a250c39bd0415492ffe941756ad72e |
| institution | Directory Open Access Journal |
| issn | 0042-4625 |
| language | Russian |
| last_indexed | 2024-04-10T02:23:29Z |
| publishDate | 2015-10-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj.art-34a250c39bd0415492ffe941756ad72e2023-03-13T08:09:09ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252015-10-011745223110.24884/0042-4625-2015-174-5-22-31111SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTSN. A. Maistrenko0P. N. Romashchenko1A. S. Pryadko2A. K. Aliev3S. M. Kirov Military Medical AcademyS. M. Kirov Military Medical AcademyS. M. Kirov Military Medical AcademyS. M. Kirov Military Medical AcademyThe results of examination and treatment were analyzed in 51 patients with iatrogenic injuries of the bile-excreting ducts. Patients were divided into 5 groups according to international classification (EAES, 2013). It depended on the time of detection, the nature and scale of damage of the bile ducts, mechanism of injury, development of infectious and septic complications. Injuries of the main bile duct were detected intraoperatively (n=14). The complete intersection was in 10 patients (the first group) and the edge intersection - in 4 cases (the second group). Iatrogenic injuries of the bile-excreting ducts were revealed in 37 patients in postoperative period. There were the complete intersections in 28 cases (the third group) and the edge intersections - in 7 cases (the fifth group). Injuries of additional bile ducts were determined in 2 patients (the fifth group). An analysis of the main qualifying features of iatrogenic injuries of the bile-excreting ducts allowed defining indications to reconstructive-restorative surgery in 60,8% patients, restorative operations - in 29,4%, an external drainage - in 5,8% and reclipping of additional bile ducts in relaparoscopy - in 3,9%. The rational surgical approach allowed obtaining perfect results in 65,8% and good, satisfactory results in immediate and long-term period with low postoperative lethality of 1,95%. The study of diagnostics results and treatment of the patients with iatrogenic injuries of the bile-excreting ducts indicated about reasonability of assessment of main factors, which are based on iatrogenic injuries according to the EAES classification. An individual program of examination and more rational variant of surgery could be chosen due to this approach, which provides minimization of negative results and good quality of life.https://www.vestnik-grekova.ru/jour/article/view/112iatrogenicbile-excreting ductsinjuriestreatment of bile duct injury |
| spellingShingle | N. A. Maistrenko P. N. Romashchenko A. S. Pryadko A. K. Aliev SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS Вестник хирургии имени И.И. Грекова iatrogenic bile-excreting ducts injuries treatment of bile duct injury |
| title | SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS |
| title_full | SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS |
| title_fullStr | SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS |
| title_full_unstemmed | SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS |
| title_short | SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS |
| title_sort | substantiation of surgical approach in iatrogenic injuries of the bile excreting ducts |
| topic | iatrogenic bile-excreting ducts injuries treatment of bile duct injury |
| url | https://www.vestnik-grekova.ru/jour/article/view/112 |
| work_keys_str_mv | AT namaistrenko substantiationofsurgicalapproachiniatrogenicinjuriesofthebileexcretingducts AT pnromashchenko substantiationofsurgicalapproachiniatrogenicinjuriesofthebileexcretingducts AT aspryadko substantiationofsurgicalapproachiniatrogenicinjuriesofthebileexcretingducts AT akaliev substantiationofsurgicalapproachiniatrogenicinjuriesofthebileexcretingducts |