"Fresh" injuries of the extrahepatic bile ducts
DOI:
https://doi.org/10.11603/2414-4533.2018.1.8854Keywords:
cholecystectomy, iatrogenic damage of main bile ducts, risk factors, prevention, surgical treatment.Abstract
Scientific achievements of modern medicine and surgery significantly improved visualization and diagnosis methods. Because of it the number of patients with pathology of the liver and bile ducts has been increased greatly. As a consequence we observe the increase of amount of surgical operations, both open and laparoscopic. There are more than 100 000 cholecystectomies in Russia, near 700 000 in US and near 20 000 in Uzbekistan each year. Increased amount of surgical interventions on bile ducts accompanied by higher quantity of iatrogenic complications and its damage.
It was analyzed clinical cases (national and foreign) since 1990s considering the reasons, risk factors, favorable circumstances, prevention and treatment of iatrogenic damages of extrahepatic biliary ducts, including so called “fresh” one.
Different types of classifications, risks factors are mentioned in the paper. Variety of instrumental methods of diagnosis are compiled (percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography, magnetic resonance (MR) imaging and computed tomography (CT), sonography); methods of prophylaxis, and peculiarities of its applying.
Obtained data testify that such factors as duration of illness, the character of surgical intervention (planned or urgent), bile duct diameter, professional experience and qualification of surgeon have no effect at the possibility of extrahepatic bile ducts damage.
All abovementioned circumstances indicate the importance of further improvements and systemic review of the problem of iatrogenic injury of bile ducts during surgical interventions.
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