Method of reconstructive surgery for damaged extrahepatic bile ducts: immediate and long-term results
https://doi.org/10.23873/2074-0506-2022-14-1-34-44
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.
About the Authors
A. B. Sidorenko
Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy
Russian Federation
Russian Federation
Aleksey B. Sidorenko, Surgeon, Research Associate, Liver Transplantation and Surgery Department
61/2 Shchepkin St., Moscow 129110
Y. I. Zakharov
Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy
Russian Federation
Russian Federation
Yuriy I. Zakharov, Cand. Sci (Med.), Senior Researcher of the Department of Abdominal Surgery
61/2 Shchepkin St., Moscow 129110
Ya. G. Moysyuk
Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy
Russian Federation
Russian Federation
Yan G. Moysyuk, Prof., Dr. Sci. (Med.), Head of Transplantology Department
61/2 Shchepkin St., Moscow 129110
References
1. Artemeva NN, Vishnevskiy VA, Kokhanenko NYu, Kulezneva YuV, Efanov MG, Shapovalyants SG, et al. Povrezhdeniya i rubtsovye striktury zhelchnykh protokov: rukovodstvo dlya vrachey. Sankt-Peterburg: SpetsLit Publ.; 2018. (In Russ.).
2. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25(10):1241–1244. PMID: 11596882 https://doi.org/10.1007/s00268-001-0102-8
3. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180(1):101–125. PMID: 8000648
4. Galperin EI, Chevokin AYu. Intraoperative injuries of bile ducts. Khirurgiya. 2010;10:4-10. (In Russ.).
5. Martinez-Lopez S, Upasani V, Pandanaboyana S, Attia M, Toogood G, Lodge P, et al. Delayed referral to specialist centre increases morbidity in patients with bile duct injury (BDI) after laparoscopic cholecystectomy (LC). Int J Surg. 2017;44:82–86. PMID: 28629763 https://doi.org/10.1016/j.ijsu.2017.06.042
6. Schreuder AM, Busch OR, Besselink MG, Ignatavicius P, Gulbinas A, Barauskas G, et al. Long-term impact of iatrogenic bile duct injury. Dig Surg. 2020;37(1):10–21. PMID: 30654363 https://doi.org/10.1159/000496432
7. Resolution of IO "Association of Surgeon-Hepatologists" Executive Board Plenary Session. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(4):124-125. (In Russ.).
8. Jabłońska B, Lampe P. Iatrogenic bile duct injuries: etiology, diagnosis and management. World J Gastroenterol. 2009;15(33):4097–4104. PMID: 19725140 https://doi.org/10.3748/wjg.15.4097
9. Kulezneva YuV, Melekhina OV, Kurmanseitova LI, Efanov MG, Tsvirkun VV, Alikhanov RB, et al. X-ray surgical treatment of benign strictures of biliodigestive anastomosis: questions for discussion. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017;22(3):45–54. (In Russ.). https://doi.org/10.16931/1995-5464.2017345-54
10. Visrodia KH, Tabibian JH, Baron TH. Endoscopic management of benign biliary strictures. World J Gastrointest Endosc. 2015;7(11):1003–1013. PMID: 26322153 https://doi.org/10.4253/wjge.v7.i11.1003
11. Filizhanko VN, Lobakov AI, Sidorenko AB, Sachechelashvili GL, Zakharov YuI, Rumyantsev VB, et al. Patent № 2472456 C1 Russian Federation, IPC A61B 17/00. Method of treating diseases and traumatic injuries of extrahepatic bile ducts. № 2011123149/14. Stated June 9, 2011; published January 20, 2013. Applicant GBUZ MO MONIKI im. M.F. Vladimirskogo. Available at: https://www.elibrary.ru/download/elibrary_37505086_47994515.pdf [Accessed January 10, 2022]. (In Russ.).
12. Filizhanko VN, Lobakov AI, Sidorenko AB. Method of extrahepatic bile ducts reconstruction with formation of an access for minimally invasive interventions. Almanac of Clinical Medicine. 2014;(33):77–80. (In Russ.). https://doi.org/10.18786/2072-0505-2014-33-77-80
13. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213. PMID: 15273542 https://doi.org/10.1097/01.sla.0000133083.54934.ae
14. Terblanche J, Worthley CS, Spence RA, Krige JE. High or low hepaticojejunostomy for bile duct strictures? Surgery. 1990;108(5):828–834. PMID: 2237762
15. Quencer KB, Tadros AS, Marashi KB, Cizman Z, Reiner E, O'Hara R, et al. Bleeding after percutaneous transhepatic biliary drainage: incidence, causes and treatments. J Clin Med. 2018;7(5):94. PMID: 29723964 https://doi.org/10.3390/jcm7050094
16. Hamad MA, El-Amin H. Bilio-enterogastrostomy: prospective assessment of a modified biliary reconstruction with facilitated future endoscopic access. BMC Surg. 2012;12:9. PMID: 22720668 https://doi.org/10.1186/1471-2482-12-9
17. Felder SI, Menon VG, Nissen NN, Margulies DR, Lo S, Colquhoun SD. Hepaticojejunostomy using shortlimb Roux-en-Y reconstruction. JAMA Surg. 2013;148(3):253–257. PMID: 23553273 https://doi.org/10.1001/jamasurg.2013.601
18. Razdrogin VA, Gerasimovski NV, Sokolov VI, Anosenko SA. Endoscopic correction of the biliodigestive anastomosis patency. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2009;14(1):106–108. (In Russ.).
19. Jayasundara JA, de Silva WM, Pathirana AA. Therapeutic value and outcome of gastric access loops created during hepaticojejunostomy for iatrogenic bile duct injuries. Surgeon. 2010;8(6):325–329. PMID: 20950771 https://doi.org/10.1016/j.surge.2010.05.009
20. Sitaram V, Perakath B, Chacko A, Ramakrishna BS, Kurian G, Khanduri P. Gastric access loop in hepaticojejunostomy. Br J Surg. 1998;85(1):110. PMID: 9462398 https://doi.org/10.1046/j.1365-2168.1998.00523.x
21. Selvakumar E, Rajendran S, Balachandar TG, Kannan DG, Jeswanth S, Ravichandran P, et al. Long-term outcome of gastric access loop in hepaticojejunostomy. Hepatobiliary Pancreat Dis Int. 2008;7(2):152–155. PMID: 18397849
Review
For citations:
Sidorenko A.B., Zakharov Y.I., Moysyuk Ya.G. Method of reconstructive surgery for damaged extrahepatic bile ducts: immediate and long-term results. Transplantologiya. The Russian Journal of Transplantation. 2022;14(1):34-44. https://doi.org/10.23873/2074-0506-2022-14-1-34-44
Views:
486
