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Cirugía y cirujanos
versión On-line ISSN 2444-054Xversión impresa ISSN 0009-7411
Resumen
VARGAS-SAHAGUN, César M.; ALONSO-LOPEZ, Elsa P.; ORTIZ-HIGAREDA, Vanessa y MARTINEZ-ORDAZ, José L.. Incidence of vascular lesions associated with disruption of the bile duct secondary to cholecystectomy. Cir. cir. [online]. 2023, vol.91, n.2, pp.162-170. Epub 16-Mayo-2023. ISSN 2444-054X. https://doi.org/10.24875/ciru.21000738.
Background.
One of the most serious complications of cholecystectomy is bile duct disruption, which can be associated with concomitant vascular injury in up to 3.4%. The incidence, demographic characteristics and treatment are underreported worldwide.
Objective.
To determine the incidence of vascular lesions in patients with a diagnosis of bile duct disruption secondary to cholecystectomy from January 1, 2015 to December 31, 2019, confirmed by preoperative CT angiography or intraoperative findings.
Method.
Retrospective, observational and analytical study of a series of cases between 2015 and 2019. Where a total of 144 cases of bile duct disruption were found, 15 cases (10%) with concomitant vascular injury.
Results.
The most frequent vascular injury was of the right hepatic artery in 13 patients (87%). The level of biliary disruption most frequently associated was Strasberg E3 and E4 in 5 patients (36%), respectively. The treatment of vascular injury was ligation of the injured vessel in 11 patients (73%). The treatment established for the repair of biliary disruption was the hepatic jejunum anastomosis in 14 patients (93%).
Conclusions.
The presence of injury at the level of the right hepatic artery is the most frequent and its ligation did not show a significant impact on biliodigestive reconstruction, as long as an adequate technique is performed (Hepp-Couinaud).
Palabras llave : Bile duct disease; Vascular injury; Cholecystectomy.