Langzeitverlauf nach Gallengangverletzung durch laparoskopische Cholecystektomie und Rekonstruktion durch ein Jejunuminterponat

Abstract

The follow-up of patients with severe bile duct lesions after laparoscopic cholecystectomy often shows secondary complications. We report on a female patient suffering from long-lasting complications after bile duct injury and early reconstruction by end-to-end anastomosis via a T-tube drainage. More than 5 years later and after multiple dilatation and stenting of the bile duct stenosis the patient was treated with an expanding metal stent. The severe cholangitis persisted. So the patient was operated on: bile duct and connected stent were resected. The reconstruction was performed with an isoperistaltic jejunal conduit. More than 24 months later the patient is healthy and at work again.

Surgical management of bile duct injuries following laparoscopic cholecystectomy: analysis and follow-up of 28 cases

“…This procedure is widely accepted and can be performed with acceptable rates of immediate and late complications [5,12,17,18,19]. Reconstruction via jejunal interposition has been proposed as an alternative [20,21]. The advantages of this technically demanding procedure include the feasibility of both ERC imaging and endoscopic intervention as well as a proposed long-term benefit due to the retained function of the papilla of Vater.…”