Use of an opened umbilical vein patch for the reconstruction of the injured biliary tract

Springer Science and Business Media LLC - Tập 14 - Trang 270-275 - 2007
Masashi Watanabe1, Kunihiro Yamazaki1, Masaru Tsuchiya1, Yuichiro Otsuka1, Akira Tamura1, Kontoku Shimokawa1, Hironori Kaneko1, Tatsuo Teramoto1
1Department of Surgery, Omori Hospital, Toho University School of Medicine, Tokyo, Japan

Tóm tắt

When iatrogenic biliary tract injury occurs, there is the risk of complications such as bile leak and biliary stricture, and hepaticojejunostomy is the conventional procedure used for injury repair. However, this procedure can be complicated by retrograde biliary tract infection and the procedure can destroy the normal anatomical structure. We report here a method of end-to-end biliary tract reconstruction that uses an opened umbilical vein (OUV) patch and two stents to reduce bile leakage and biliary stricture formation following injury to the common bile duct or right main bile duct. The postoperative courses of four patients are reviewed. In two of the patients, there was a small amount of postoperative bile drainage (for 3 days in the first patient and 2 days in the second patient). Of the two stents, the first stent was removed 1 month postoperatively, and the second stent at 2 to 3 months postoperatively. Three patients have returned to normal activity without symptoms after 44, 62, and 93 months, respectively. One patient died of a liver tumor recurrence in the fifth postoperative month, without a biliary problem. An OUV patch for end-to-end biliary reconstruction reduced the volume and duration of bile leakage. Further research is needed to accurately evaluate the stenting period so as to reduce its duration.

Tài liệu tham khảo

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