DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160504

Current perspective in the treatment of bile duct injuries

Juan José Granados-Romero, Aranza Guadalupe Estrada-Mata, Mariana Espejel-Deloiza, Jesús Carlos Ceballos-Villalva, Ericka Hazzel Contreras-Flores, Benjamín León-Mancilla, Germán Eduardo Mendoza-Barrera, Carlos Aarón Méndez-Celis, Alan Isaac Valderrama-Treviño

Abstract


The laparoscopic cholecystectomy is considered the gold standard for the treatment of benign gallbladder disease, which is associated with an increased incidence of biliary injuries. These types of injuries are multicausal, and anatomical variations or anatomical perception errors are the most common risk factors. The objective of this study is to describe the evolution in the management of bile duct injuries and actual, diagnostic tools, incidence, prognosis and treatment. A literature research about diagnosis and treatment of iatrogenic bile duct injuries as well as their impact on the incidence of morbidity and mortality, based on a 30-year period, was performed on Medline, Cochrane, Embase, MedScape and PubMed database, for all studies that met the eligibility criteria. A thorough quality assessment of all included studies was performed. Synthesis of the results was achieved by narrative review. The bile duct injury is a complication that requires a complex therapy and multidisciplinary management. Reconstruction and treatment techniques have been evolving. The selection of adequate treatment will impact on the patient´s quality of life. The results of the existing studies reporting on iatrogenic bile duct injuries are useful; because the iatrogenic bile duct injuries are complex alterations and constitute one of the most serious complications of a cholecystectomy and require a comprehensive approach, immediate repair, proper drainage and timely referral to adequate treatment to improve long-term prognosis. According to the literature review, currently there better treatments such as absorbable prosthesis, which improve the prognosis and patient´s quality of life, and represent less risk of complications in short/long term.

 


Keywords


Bile duct injuries, Laparoscopic cholecystectomy, Bile duct prosthesis, Diagnosis, Treatment, Mortality

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