RESTORATIVE AND RECONSTRUCTIVE OPERATIONS FOR IATROGENIC INJURY TO EXTRAHEPATIC BILE DUCTS

Abstract

Presented Results of treatment of 102 patients with intraoperative bile duct injuries. Bile duct injuries during CE were 1.3% and were observed during LCE in 2/3 of cases, with 59.8% of cases involving peripheral bile duct injuries and 48.2% involving main bile duct injuries. High Roux -en-Y GEA using precision equipment is the operation of choice for intraoperative CE intersection and excision. Reconstructive surgeries are indicated for marginal CE injury; BBA and GDA application are not recommended due to the high risk of anastomotic strictures. The treatment and diagnostic algorithm using endoscopic transduodenal interventions, ultrasound- guided puncture methods, and laparoscopy made it possible to avoid relaparotomy in 96.7% of patients with intraoperative injuries to the peripheral bile ducts. Correction of bile duct damage when detected intraoperatively is accompanied by a significantly lower number of complications in the immediate (10%) and late (25%) periods of treatment than when detected in the postoperative period (38.1% and 41.2%, respectively, with a mortality rate of 14.3%).