Resection and Transplantation Technologies in Surgery of High Posttraumatic Cicatricial Strictures of the Bile Ducts
https://doi.org/10.16931/1995-5464.2017461-65
Abstract
Aim. To improve surgical treatment of high posttraumatic biliary strictures.
Material and Methods. The study included 17 patients with high scarry strictures of the bile ducts (SSBD) complicated by recurrent cholangitis and biliary cirrhosis. All of them underwent 3–8 various reconstructive surgeries. The cause of SSBD was iatrogenic injury of the bile ducts in all cases. E.I. Galperin and H. Bismuth classification was used to describe the type of strictures.
Results. Various types of liver resection were carried out in 14 out of 17 cases: atypical resection of segment IV followed by bihepaticoenterostomy (4), left-sided (n = 6) and right-sided (n = 4) hemihepatectomy followed by biliodigestive anastomosis with lobar hepatic duct (4), three (3) and two (3) segmental ducts. Postoperative complications were observed in 3 cases with 1 death. Additionally, related right liver lobe transplantation (LT) was performed in 3 cases.
Conclusion. Thus, resection and transplantation surgical interventions improve the outcomes in patients with high SSBD complicated by biliary cirrhosis and recurrent cholangitis.
About the Authors
K. M. Kurbonov
Department of Surgical Diseases №1, Abuali ibni Sino Tajik State Medical University
Tajikistan
Tajikistan
Kurbonov Karimkhon Murodovich – Doct. of Med. Sci., Professor, Head of the Surgical Diseases Department №1 of the Abuаli ibni Sino Tajik State Medical University, Academician of the Academy of Medical Sciences of the Republic of Tajikistan, Honored Worker of Science and Technology of the Republic of Tajikistan.
Rudaki avenue, Dushanbe, 734003, TajikistanN. A. Rasulov
Department of Surgical Diseases №1, Abuali ibni Sino Tajik State Medical University
Tajikistan
Tajikistan
Rasulov Nazir Aminovich – Cand. of Med. Sci., Associate Professor, Head of the Surgical Department at the Institute of Postgraduate Education in Healthcare System of the Republic of Tajikistan.
Rudaki avenue, Dushanbe, 734003, TajikistanK. R. Nazirboev
Department of Surgical Diseases №1, Abuali ibni Sino Tajik State Medical University
Tajikistan
Tajikistan
Nazirboev Kakhramon Ruziboevich – Cand. of Med. Sci., Assistant of the Surgical Diseases Department of №1 of the Abuali ibni Sino Tajik State Medical University.
Rudaki avenue, Dushanbe, 734003, Tajikistan
U. U. Mansurov
Department of Surgical Diseases №1, Abuali ibni Sino Tajik State Medical University
Tajikistan
Tajikistan
Mansurov Usmon Umarovich – Full-time Postgraduate Student of Surgical Diseases Department №1 of the Abuаli ibni Sino Tajik State Medical University.
Rudaki avenue, Dushanbe, 734003, TajikistanReferences
1. Nechay A.I., Novikov K.V. Iatrogenic injuries of the bile ducts in cholecystectomy and stomach resection. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2006; 11 (4): 95–100. (In Russian)
2. Belokonev V.I., Khunkuy I., Kovaleva Z.V. The choice of surgical method in patients with “fresh” trauma and common bile duct strictures. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. 2013; 26 (2): 42–53. (In Russian)
3. Vafin A.Z. Surgical treatment of patients with “fresh” lesions of extrahepatic bile ducts. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2014; 19 (1): 75–80. (In Russian)
4. Khoronko Yu.V., Ermolaev A.N., Khoronko E.Yu. Controversial issues in the treatment of iatrogenic lesions of extrahepatic bile ducts and their consequences. Meditsinskiy vestnik Yuga Rossii. 2014; 3: 96–99. (In Russian)
5. Agaev B.A., Muslimov G.F., Alieva G.R., Ibragimov T.R. Prognostic factors affecting the outcome of postoperative biliary strictures and injuries management. Khirurgiya. Zhurnal im. N.I. Pirogova. 2010; 12: 44–50. (In Russian)
6. Galperin E.I. Causes of development, diagnosis and surgical treatment of strictures of lobar and segmental hepatic ducts. Khirurgiya. Zhurnal im. N.I. Pirogova. 2005; 8: 64–70. (In Russian)
7. Tarasenko S.V. The method of tetrahepaticojejunostomy for high biliary stricture. Khirurgiya. Zhurnal im. N.I. Pirogova. 2013; 10: 18–21. (In Russian)
8. Costamagna C., Boškoski I. Current treatment of benign biliary strictures. Ann. Gastroenterol. 2013; 26 (1): 37–41. DOI: 10.3748/wjg.v13.i26.3531.
9. Chuang K.I., Corley D., Postlewaite D.A. Does increased experience with laparoscopic cholecystectomy yield more complex bile duct injuries? Am. J. Surg. 2012; 203 (4): 480–487. DOI: 10.1016/j.amjsurg.2011.08.018.
10. Li J. Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy: a challenging situation. J. Gastrointest. Surg. 2010; 14 (2): 344–351. DOI: 10.1007/s11605-009-1087-0.
11. Galperin E.I., Chevokin A.Yu., Kuzovlev N.F. Diagnosis and treatment of various types of high cicatricial strictures of the hepatic ducts. Khirurgiya. Zhurnal im. N.I. Pirogova. 2004; 5: 26–31. (In Russian)
12. Zhuravlev V.A., Rusinov V.M., Buldakov V.V. Opit khirurgicheskogo lecheniya visocikh strictur zhelchnyh protocov [Experience in surgical treatment of high biliary strictures]. Actual problems of surgical hepatology: abstracts of the reports of the XVII international congress of surgeons-hepatologists of Russia and CIS countries. Ufa. 2010. P. 43–44. (In Russian)
13. Zhuravlev V.A., Rusinov V.M., Buldakov V.V. Biliary reconstruction in liver resection. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2011; 16 (4): 46–50. (In Russian)
14. Vishnevsky V.A., Nazarenko N.A. Liver resections in the treatment of posttraumatic cicatricial strictures of the bile ducts and biliary-suppurative hepatic fistula. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2003; 8 (2): 85. (In Russian)
15. Semenkov A.V., Kim E.F., Fomin A.V. Liver transplantation for secondary liver cirrhosis. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2013; 18 (3): 140–147. (In Russian)
16. Rukovodstvo po khirurgii zhelchnykh putej (rukovodstvo dlya vrachej) [Guidelines for biliary surgery (a management for doctors)] 2-e izd. Ed. Galperin E.I., Vetshev P.S. Moscow: Vidar-M, 2009. 568 р. (In Russian)
17. Bismuth H. Biliary strictures: classification based on the principles of surgical treatment. World J. Surg. 2001; 25 (10): 1241–1244. DOI: 10:1007/S00268-001-0102-8.
18. Klimov A.E. Diagnostica i khirurgicheskoе lecheniyе stictur zhelchnyh protocov. [Diagnosis and surgical treatment of strictures of the bile ducts: avtoref. dis. … doct. med. sci.]. Moscow, 2005. 38 p. (In Russian)
19. Olisov O.D. Postravmatichesciye sticturi zhelchnyh protocov: Diagnostica, lecheniya, rezultati. [Post-traumatic stricture of the bile duct. Diagnosis, treatment, results: avtoref. dis. … cand. med. sci.]. Moscow, 2006. 22 p. (In Russian)
20. Garmaev B.G. Кhirurgicheskoе lecheniyе рostravmatichescikh rubtsovikh strictur dolevikh i segmentarnikh pechenochnyh protocov. [Surgical treatment of posttraumatic cicatricial strictures of lobar and segmental hepatic ducts: avtoref. dis. … cand. med. sci.]. Moscow, 2005. 22 p. (In Russian)
Review
For citations:
Kurbonov K.M., Rasulov N.A., Nazirboev K.R., Mansurov U.U. Resection and Transplantation Technologies in Surgery of High Posttraumatic Cicatricial Strictures of the Bile Ducts. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017;22(4):61-65. (In Russ.) https://doi.org/10.16931/1995-5464.2017461-65
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