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Iatrogenic bile duct injuries (BDIs) and subsequent benign biliary stricture is a medical catastrophe which is associated with significant perioperative morbidity and mortality,reduced long-term survival rate and poor quality of life.For most major BDIs (Strasberg classification E1-E4),the recommended method of repair is hepaticojejunostomy (HJ).We conducted a retrospective review aiming to examine the surgical technique of high HJ at our institution.This review highlights 4 aspects in the operation which include the hepatoduodenal ligament exposure,hepatic artery and its branches protection,exposing the intrahepatic bile duct above the stricture plane,and HJ techniques.Overall,the optimal long-term result of surgical management depends on the availability of experienced hepatobiliary surgeons and a considerable large HJ anastomosis above the stricture.

作者:彭淑牖;钱浩然

来源:中华消化外科杂志 2012 年 11卷 5期

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作者:
彭淑牖;钱浩然
来源:
中华消化外科杂志 2012 年 11卷 5期
标签:
胆管狭窄,良性 胆管损伤,医源性 肝管空肠吻合术 Biliary stricture,benign Bile duct injuries,iatrogenic Hepaticojejunostomy
Iatrogenic bile duct injuries (BDIs) and subsequent benign biliary stricture is a medical catastrophe which is associated with significant perioperative morbidity and mortality,reduced long-term survival rate and poor quality of life.For most major BDIs (Strasberg classification E1-E4),the recommended method of repair is hepaticojejunostomy (HJ).We conducted a retrospective review aiming to examine the surgical technique of high HJ at our institution.This review highlights 4 aspects in the operation which include the hepatoduodenal ligament exposure,hepatic artery and its branches protection,exposing the intrahepatic bile duct above the stricture plane,and HJ techniques.Overall,the optimal long-term result of surgical management depends on the availability of experienced hepatobiliary surgeons and a considerable large HJ anastomosis above the stricture.