[Combined injuries of bile ducts and hepatic artery branches in cholecystectomy].

Results of treatment of 25 patients with combined injuries of bile ducts and the common hepatic artery in performing cholecystectomy were studied. In 19 (73.1%) patients the injuries were noted during open and in 7 (26.9%) patients during laparoscopic cholecystectomy. The patients needed multimodal strategy of treatment with reference to the time when the diagnosis was made and to the characteristics of clinical course. Positive results of treatment were obtained in 84.6% of cases, lethality made up 3.9%.

[Combined injury of biliary ducts and vessels during cholecystectomy: peculiarities of clinical course and surgical tactics].

The results of treatment of 56 patients, in whom in 1984-2010 yrs, while performing cholecystectomy, a biliary duct injury have occurred, were analyzed, including 26 (main group)--with combined injury of biliary ducts and brunches of common hepatic artery, 30 (control group)--with isolated complete biliary ducts. High hepaticojejunostomy have constituted the main method of operation in a control group. In the main group in 2 patients there were attempts made to restore the arterial blood flow with subsequent performance of reconstructive intervention on biliary ducts. In 16 (61.5%) patients, due to adequate collateral blood supply presence, the bile outflow was restored using hepaticojejunostomy formation, and in 8 (30.8%)--hepatic resection of various volume was needed, because of hepatic abscesses formation. The results of treatment of patients in these groups have differed not essentially, while applying differentiated approach (positive results were achieved in 93.3 and 84.6% of patients, accordingly). So, in patients with combined injury of biliary ducts and branches of hepatic artery, while performance of cholecystectomy, it is necessary to apply multimodal tactics of treatment, taking into account the peculiarities of clinical course.