Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage
The OBJECTIVE was to demonstrate an original minimally invasive way to restore the continuity of the lobar duct after its complete intersection.METHODS AND MATERIALS. The study included 3 patients aged 38, 56 and 69 years who underwent laparoscopic cholecystectomy for cholelithiasis, cholecystolithi...
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| Format: | Article |
| Language: | Russian |
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Pavlov First Saint Petersburg State Medical University
2022-09-01
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| Series: | Вестник хирургии имени И.И. Грекова |
| Subjects: | |
| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/2136 |
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| author | R. G. Avanesyan M. P. Korolev M. Yu. Pletnev S. N. Sabri T. V. Amirkhanyan |
| author_facet | R. G. Avanesyan M. P. Korolev M. Yu. Pletnev S. N. Sabri T. V. Amirkhanyan |
| author_sort | R. G. Avanesyan |
| collection | DOAJ |
| description | The OBJECTIVE was to demonstrate an original minimally invasive way to restore the continuity of the lobar duct after its complete intersection.METHODS AND MATERIALS. The study included 3 patients aged 38, 56 and 69 years who underwent laparoscopic cholecystectomy for cholelithiasis, cholecystolithiasis in various medical institutions of the city. In all patients, the intersection of the right lobar duct with the formation of an external biliary fistula in the postoperative period was revealed. RESULTS. All patients underwent recanalization of the crossed duct on the first attempt. After the fistula was formed on the frame drainage, the flow of bile through the external biliary fistula gradually regressed: in one patient, bile leakage from the abdominal cavity stopped after two days, in two patients after a week. Drainages from the subhepatic space were removed in all patients on the 9th day after restoration of the continuity of the intersect duct. Kehr's drainage was removed after 12 days in one patient, after 21 days in another. Retrograde external drainage was removed from the third patient on the 5th day after restoration of the patency of the duct on the frame drainage. After control X-ray images, the external-internal frame drainages were blocked for patients on the 5-10th day after the operation. There were no leaks of contrast agent through the restored section of the duct.CONCLUSION. The developed method of minimally invasive restoration of continuity and patency of the intersected and excised hepatic duct is an alternative to the traditional reconstructive biliodigestive bypass surgery. Long-term frame drainage of the bile duct in the area of damage allows forming sufficient diameter for an unobstructed passage of bile. |
| first_indexed | 2024-04-10T02:18:46Z |
| format | Article |
| id | doaj.art-acec952d1bba45e587921351e54496f2 |
| institution | Directory Open Access Journal |
| issn | 0042-4625 |
| language | Russian |
| last_indexed | 2024-04-10T02:18:46Z |
| publishDate | 2022-09-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj.art-acec952d1bba45e587921351e54496f22023-03-13T08:09:21ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252022-09-011811606510.24884/0042-4625-2022-181-1-60-651439Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damageR. G. Avanesyan0M. P. Korolev1M. Yu. Pletnev2S. N. Sabri3T. V. Amirkhanyan4St.-Petersburg State Pediatric Medical University; Mariinsky City HospitalSt.-Petersburg State Pediatric Medical University; Mariinsky City HospitalSt.-Petersburg State Pediatric Medical University; Mariinsky City HospitalSt.-Petersburg State Pediatric Medical UniversityMariinsky City HospitalThe OBJECTIVE was to demonstrate an original minimally invasive way to restore the continuity of the lobar duct after its complete intersection.METHODS AND MATERIALS. The study included 3 patients aged 38, 56 and 69 years who underwent laparoscopic cholecystectomy for cholelithiasis, cholecystolithiasis in various medical institutions of the city. In all patients, the intersection of the right lobar duct with the formation of an external biliary fistula in the postoperative period was revealed. RESULTS. All patients underwent recanalization of the crossed duct on the first attempt. After the fistula was formed on the frame drainage, the flow of bile through the external biliary fistula gradually regressed: in one patient, bile leakage from the abdominal cavity stopped after two days, in two patients after a week. Drainages from the subhepatic space were removed in all patients on the 9th day after restoration of the continuity of the intersect duct. Kehr's drainage was removed after 12 days in one patient, after 21 days in another. Retrograde external drainage was removed from the third patient on the 5th day after restoration of the patency of the duct on the frame drainage. After control X-ray images, the external-internal frame drainages were blocked for patients on the 5-10th day after the operation. There were no leaks of contrast agent through the restored section of the duct.CONCLUSION. The developed method of minimally invasive restoration of continuity and patency of the intersected and excised hepatic duct is an alternative to the traditional reconstructive biliodigestive bypass surgery. Long-term frame drainage of the bile duct in the area of damage allows forming sufficient diameter for an unobstructed passage of bile.https://www.vestnik-grekova.ru/jour/article/view/2136iatrogenic bile duct injuryminimally invasive treatmentbiliary fistula |
| spellingShingle | R. G. Avanesyan M. P. Korolev M. Yu. Pletnev S. N. Sabri T. V. Amirkhanyan Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage Вестник хирургии имени И.И. Грекова iatrogenic bile duct injury minimally invasive treatment biliary fistula |
| title | Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| title_full | Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| title_fullStr | Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| title_full_unstemmed | Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| title_short | Original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| title_sort | original method for restoring the continuity of the lobar duct of the liver in case of iatrogenic damage |
| topic | iatrogenic bile duct injury minimally invasive treatment biliary fistula |
| url | https://www.vestnik-grekova.ru/jour/article/view/2136 |
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