Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience.

摘要: BACKGROUND: The 1990s were associated with a dramatic increase in bile duct injuries the widespread use of laparoscopic cholecystectomy (LC). Interventional radiology has an integral role diagnosing and managing these injuries. Definitive percutaneous management balloon dilatation might be possible select patients intact biliary-enteric continuity, but longterm data are limited. STUDY DESIGN: Data collected prospectively on 51 consecutive major stricture or injury LC, treated management, January 1, 1990, to December 31, 1999. Percutaneous transhepatic cholangiography biliary catheter placement followed by stenting. Outcomes assessed direct patient contact hospital records. RESULTS: All completed treatment, 50 (98%) stent free at mean followup 76 months. success rate was 58.8%, without need for subsequent intervention. Presenting symptoms, level injury, number stents dilatations did not predict outcomes. treatment more likely fail stented less than 4 months (p < 0.001). Operative repair Hopkins before predictive successful outcome 0.05). Including operations outcomes achieved 98% patients. CONCLUSIONS: Major after LC remain clinical challenge. Although surgical reconstruction is cornerstone, selected continuity can achieve long-term results definitive management. combination virtually all