In this study, doctors from Germany examined the correlation of combined bile duct and vascular injuries following laparoscopic cholecystectomy. The team also evaluated the impact of these injuries on patient morbidity.
They evaluated 54 patients with bile duct injuries between 1990 and 2002.
Of the 54 patients, 46 had a Roux-en-Y hepaticojejunostomy, 11 had a concomitant vascular injury. Arterial reconstruction in addition to Roux-en-Y hepaticojejunostomy was performed in 2 patients.
The doctors found that the rate of postoperative biliary complications was 22%.
|The rate of postoperative biliary complications was 22%.|
The team identified 2 risk factors for the development of biliary complications after reconstructive surgery. The first was combined bile duct and hepatic arterial injuries and the second, surgical repair in active peritonitis.
The team found that a successful outcome was achieved in 91% of patients.
Dr Sven Schmidt and colleagues concluded, "The outcome of bile duct reconstruction is worse in patients with concomitant arterial injuries".
"We therefore recommend the assessment of patients with major bile duct injuries for additional vascular injuries".
"Further studies are needed to evaluate the importance of hepatic arterial revascularization in early recognized injuries to the long-term outcome of bile duct reconstructions".