Endoscopy 2018; 50(04): S109-S110
DOI: 10.1055/s-0038-1637354
ESGE Days 2018 ePoster Podium presentations
20.04.2018 – Complications
Georg Thieme Verlag KG Stuttgart · New York

MINIMALLY INVASIVE TREATMENT OF IATROGENIC COMPLICATIONS OF BILE DUCT SURGERY

M Korolev
1   State Pediatric Medical University of the Ministry of Healthcare of Russia, Saint-Petersburg, Russian Federation
,
L Fedotov
1   State Pediatric Medical University of the Ministry of Healthcare of Russia, Saint-Petersburg, Russian Federation
,
R Avanesian
1   State Pediatric Medical University of the Ministry of Healthcare of Russia, Saint-Petersburg, Russian Federation
,
G Lepekhin
1   State Pediatric Medical University of the Ministry of Healthcare of Russia, Saint-Petersburg, Russian Federation
,
T Amirkhanyan
1   State Pediatric Medical University of the Ministry of Healthcare of Russia, Saint-Petersburg, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

To show the effectiveness of combined miniinvasive technologies in the treatment of early complications and late consequences of damage to the bile ducts.

Methods:

Minimally invasive surgery under combined (ultrasonic, endoscopic, X-ray) control performed for 136 patients with iatrogenic injuries of the bile ducts. In the study group there were 49 men, 87 women. The average age of the men was 47,3 years, women 64,7.

Results:

Patients were divided into 2 groups:

  • patients with early complications of operations on the bile duct,

  • patients with late consequences of iatrogenic damage.

In the early complications group we included patients with intersection, clipping and ligation of the bile duct. Patients with stricture due to thermal damage, stricture biliary-biliary- and biliary-enteric anastomosis were taken to the late consequences of iatrogenic damage group. At the intersection of the duct patients underwent combined intervention aimed to restore the integrity of the duct using percutaneous and endoscopic manipulation, the purpose of which was to provide guidewire through the damaged area and frame drainage of the duct. In case of clipping or ligation of the duct, main task of the minimally invasive manipulation is conducting of the guidewire through the stricture, the balloon dilatation, frame drainage duct. The strictures of the bile ducts after reconstructive surgery and the thermal damage method are identical. You have to pass the stricture, perform dilation and frame to provide drainage ducts up to 2 years with periodic change of drainage, with a gradual extension of the diameter. Sometimes the nitinol self-expanding stent was used. The mortality was 0,74%.

Conclusions:

Each case related to damage or stricture of the bile duct requires an individual approach. In treatment of this category of patients, we believe that the combination of minimally invasive techniques is a priority in the treatment of injuries of the bile ducts.