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BILE DUCT INJURY DURING CHOLECYSTECTOMY: CAUSES, PREVENTION AND SURGICAL REPAIR IN 1979
Author(s) -
KUNE GABRIEL A.
Publication year - 1979
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1979.tb06433.x
Subject(s) - medicine , bile duct , cholecystectomy , anastomosis , surgery , cystic duct , common hepatic duct , duct (anatomy) , gallbladder , general surgery , dissection (medical) , iatrogenic injury
Bile duct injury during cholecystectomy is almost always a high Injury of the proximal common hepatic duct, because the surgeon mistakes this duct for the cystic duct and a segment of it is removed with the gallbladder. Most of these injuries are preventable by following certain principles of careful surgical dissection of the ductal system during surgery. Surgical reconstruction is always difficult, and restrlcturing of the anastomosis remains the most important problem. Recent advances in surgical technique have minimized the risk of recurrent stricture formation. At present the most suitable reconstruction for the typical high common hepatic duct lesion is a hepaticojejunostomy Roux‐en‐Y, using transhepatic intubation and a “mucosal graft” type of procedure. Biliary reconstruction was performed on 32 patients referred to the writer during the past 13 years resulting In six recurrent strictures needing a second reconstruction. At the end of 1978,10 patientsare too early to evaluate, two are dead and 20 have obtained a good final result. We must publicise the fact that cholecystectomy is a dangerous operation THE LATE DR. FRANK H. LAHEY