Open AccessGunshot injuries of the extrahepatic biliary ducts
Author(s) -
Degiannis Elias,
Khelif Karim,
Leandros Emanuel,
Boffard Kenneth,
Saadia Roger
Publication year - 2001
Publication title -
european journal of surgery
Language(s) - English
Resource type - Journals
eISSN - 1741-9271
pISSN - 1102-4151
DOI - 10.1080/110241501753171236
Subject(s) - medicine , anastomosis , surgery , roux en y anastomosis , ligation , jejunostomy , bile duct , damage control , biliary tract surgical procedures , debridement (dental) , surgical anastomosis , biliary tract , parenteral nutrition , gastric bypass , weight loss , obesity
Objective: To assess our management of gunshot injuries of the extrahepatic biliary ducts. Design: Retrospective study. Setting: Urban teaching hospital, South Africa. Subjects: 17 patients who were found to have gunshot injuries of the extrahepatic bile ducts, January 1993‐June 1998. Interventions: Packing and damage control, staged repair, or definitive repair. Main outcome measures: Morbidity and mortality: Three of the 17 died intraoperatively or postoperatively from causes unrelated to the biliary injury. Of the 14 survivors, 3 were managed initially with packing and damage control, 7 by staged repair, and 4 by definitive biliary repair. Eleven patients had a Roux‐en‐Y biliary jejunostomy, of whom 1 developed a late biliary stricture related to a postoperative anastomotic leak. End‐to‐end anastomosis of the bile duct was done for 2 patients and they both developed late biliary strictures. Ligation of the injured duct and cholecystojejunostomy was done for 1 patient. Conclusion: Roux‐en‐Y biliary‐jejunal anastomosis is appropriate in the treatment of gunshot injuries of the extrahepatic biliary ducts as there is always a degree of tissue loss and some debridement is required, making it difficult to do a tension‐free anastomosis. Copyright © 2001 Taylor and Francis Ltd.