Praktické lekárnictvo 3/2015
Iatrogenic injury of biliary tree during laparoscopic cholecystectomy
Laparoscopic cholecystectomy is one of the commonest surgical procedures in the world. However, incidence of iatrogenic laesion is higher in laparoscopy than in laparotomy. Question are the risks, which increase this serious impairment of patients. Materials and methods: The case files of all patients with iatrogenic injury of bile ducts undergoing laparoscopic cholecystectomy between 2012 and 2014 (inclusive) at I. surgical clinic UNLP in Košice were retrospectively analyzed. 924 patients underwent laparoscopy of whom one developed laesion at our workplace and four patients were admitted from other hospitals. The patients’ ages ranged from 22 to 70 years with median 45,4. 2 were males and 3 were females. Mechanism of injury was: 1x laesion of common biliary duct, 2x laesion of ductus hepaticus communis, – proximal and distal clipped duct close to duodenum, 2x laesion of common bile duct, – proximal and distal part was clipped and interrupted in the middle part. In four cases was performed reconstruction HJA sec. Roux Y, in one case eas T drain inserted in biliary tree. Conclusion: Early diagnostic of iatrogenic injury of biliary tree and next treatment is very important because of serious complications – liver cirhosis, hepatal failure and death.
Keywords: laparoscopic cholecystectomy, laesion of biliary tree, surgery, mortality, morbidity
