RT Book, Section
A1 Mathur, Amit K.
A1 Knol, James A.
A2 Minter, Rebecca M.
A2 Doherty, Gerard M.
SR Print(0)
ID 510130154
T1 Chapter 13. Management of Bile Duct Injuries and Biliary Strictures
T2 CURRENT Procedures: Surgery
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-145316-5
LK accessanesthesiology.mhmedical.com/content.aspx?aid=510130154
RD 2024/04/23
AB Iatrogenic  biliary  injuries  associated  with  laparoscopic  cholecystectomy  (most  common),  or  other  foregut  operations.Operative  approach  depends  on  the  time  the  injury  is  diagnosed  (eg,  immediately,  early  [≤  4  weeks  after  injury],  or  late  [>  4  weeks  after  injury]).  If  the  patient  is  hemodynamically  stable,  immediate  biliary  reconstruction  is  indicated  when  an  injury  is  identified  intraoperatively  during  a  laparoscopic  cholecystectomy  or  other  operation  and  a  hepatobiliary  surgeon  is  available  to  perform  the  repair.For  patients  with  early  or  late  injuries,  operative  management  typically  requires  delayed  biliary  reconstruction  with  a  biliary-enteric  anastomosis.The  aim  of  operative  intervention  is  definitive  treatment  of  patients  with  iatrogenic  common  bile  duct  or  more  proximal  biliary  injuries  after  the  residual  inflammation  from  the  acute  injury  has  resolved.If  the  injury  has  been  thoroughly  evaluated  and  the  biliary  system  has  been  sufficiently  decompressed  and  drained  for  6  weeks  or  more,  reconstruction  is  required  if  a  biliary  stricture  persists  or  if  biliary-enteric  discontinuity  remains.