Lesiones de la vía biliar en cirugía laparoscópica: análisis de 10 años de trabajo / Injuries of the biliary tract in laparoscopic surgery: analysis of 10 years of work

RESUMEN

Se realizaron análisis de 5 558 pacientes operados por cirugía mínimamente invasiva en el período comprendido entre noviembre de 1991 y marzo de 2001, en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras", Según la clasificación topográfica de lesiones totales. En 4 pacientes no se realizó el diagnóstico transoperatorio, fallecieron 2 (18,2 (por ciento) de ellos por complicaciones secundarias a esta causa. El resto recibió el tratamiento definitivo en el propio acto quirúrgico. Como tratamiento se preconizó la técnica de Hepp para secciones totales del colédoco, y la colocación de sonda en T de Kehr para las lesiones parciales. La sutura primaria se podrá realizar solo de forma excepcional(AU)

ABSTRACT

5 558 patients operated on by minimal invasive surgery at "Hermanos Ameijeiras" Clinical and Surgical Hospital were studied. The most frequent causes of lesion and the conduct to be followed in every type of lesion were determined. 11 patients with lesions of the main biliary tract (0.20 percent) were reported. According to Ballesta's topographic classification, there were 6 type I lesions, 3 type II lesions, and 2 type III lesions. There was no transoperative diagnosis in 4 patients and 2 of them (18,2 percent) died due to complications secondary to this cause. The rest received the definitive treatment in the own surgical act. Hepp´s technique was recommended to treat the total sections of the choleduchus, whereas the placement of Kehr´s T-tube was suggested to treat the partial injuries. The primary suture could only used exceptionally(AU)