DIAGNOSIS AND TREATMENT OF POSTOPERATIVE BILE LEAKAGE
https://doi.org/10.16931/1995-5464.2015490-94
Abstract
Aim. Improving the immediate results of surgical treatment of liver and biliary tract diseases.
Material and Methods. Treatment of 142 patients with postoperative bile leakage was analyzed. Sonography, ERCP, gastroscopy, CT and MRI were used in diagnostics. There were 62 (43.7%) men and 80 (56.3%) women. Postoperative bile leakage was caused by unrepaired biliary hypertension in 14.8% of cases, undiagnosed and unliquidated cystobiliary fistulas – in 40.1%, traumatic lesions of liver and biliary tract – in 10.6 %, clips and drainage tubes dislocation – in 12%, suture failure of cystic duct, common bile duct, biliodigestive anastomoses and duodenal stump – in 22,5%.
Results. Bile leakage was treated taking into account its severity and presence of bile hypertension. Endoscopic methods, EPST, biendoscopic interventions (relaparoscopy with cystic duct re-clipping), transduodenal replacement showed high efficiency. Isolated Roux loop hepaticojejunostomy was performed in severe incurable postoperative bile leakage. Complications and deaths were absent.
Conclusion. Treatment of patients with postoperative bile leakage requires an individual approach and should include conservative measures, endoscopic and surgical methods of correction.
About the Authors
K. M. Kurbonov
Abu Ali ibn Sina the Tajik State Medical University
Tajikistan
Kurbonov Karimkhon Murodovich – Doct. of Med. Sci., Professor, Academician of the Academy of Medical Sciences of Tajikistan, Head of Chair of Surgical Diseases №1 of Abu Ali ibn Sina the Tajik State Medical University
Tajikistan
Kurbonov Karimkhon Murodovich – Doct. of Med. Sci., Professor, Academician of the Academy of Medical Sciences of Tajikistan, Head of Chair of Surgical Diseases №1 of Abu Ali ibn Sina the Tajik State Medical University
N. M. Daminova
Abu Ali ibn Sina the Tajik State Medical University
Tajikistan
Daminova Nigina Madaminovna – Doct. of Med. Sci., Assistant of Chair of General Surgery №1
Tajikistan
Daminova Nigina Madaminovna – Doct. of Med. Sci., Assistant of Chair of General Surgery №1
F. I. Makhmadov
Abu Ali ibn Sina the Tajik State Medical University
Tajikistan
Tajikistan
Makhmadov Farrukh Isroilovich – Doct. of Med. Sci., Assistant Professor of Chair of Surgical Diseases №1 eases №1
For correspondence: Makhmadov Farrukh Isroilovich – 48, 42, Clara Zetkin str., Dushanbe city, Tajikistan, 734019.
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Review
For citations:
Kurbonov K.M., Daminova N.M., Makhmadov F.I. DIAGNOSIS AND TREATMENT OF POSTOPERATIVE BILE LEAKAGE. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(4):90-94. (In Russ.) https://doi.org/10.16931/1995-5464.2015490-94
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