Abstract
Background and aims
To evaluate treatment results in iatrogenic biliary injuries with concomitant vascular injuries.
Patients/Methods
Between January 1998 and May 2002 (inclusive), angiography was performed in 45 of the 105 patients treated for iatrogenic biliary tract injury. The charts of these 45 patients and 5 other patients in whom vascular injury was diagnosed at operation were evaluated retrospectively. Twenty-nine patients had concomitant vascular injury, the biliovascular injury group (BVI), and the remaining 21 patients had isolated biliary tract injury (IBTI).
Results
The most frequent initial operation was a cholecystectomy. The frequency of high-level (Bismuth III or IV) strictures was 90% in the BVI group and 62% in the IBTI group (P<0.05). Perioperative mortality was 7% in the BVI group and 5% in the IBTI group (P>0.05). The morbidity in the BVI group was significantly higher (P<0.05). Two patients in each group were lost to follow up. During a median (range) follow up of 31 months (5–51 months), a successful functional outcome was achieved in 96% of the BVI group and 100% of the IBTI group with a multimodal approach (P>0.05).
Conclusions
The frequency of high-level biliary injury and morbidity were significantly higher in the BVI group. However, concomitant vascular injury had no significant effect on mortality and medium-term outcome of biliary reconstruction. Thus, routine preoperative angiography is not recommended.
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Bilge, O., Bozkıran, S., Özden, İ. et al. The effect of concomitant vascular disruption in patients with iatrogenic biliary injuries. Langenbecks Arch Surg 388, 265–269 (2003). https://doi.org/10.1007/s00423-003-0382-6
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DOI: https://doi.org/10.1007/s00423-003-0382-6