Travmatik safra yolu yaralanmalar›nda kal›c› tedavi [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 2004; 10(4): 221-225

Travmatik safra yolu yaralanmalar›nda kal›c› tedavi

Mert Erkan1, Orhan Bilge1, İlgin Özden1, Yaman Tekant1, Koray Acarlı1, Aydın Alper1, Ali Emre1, Orhan Arıoğul1
Department of General Surgery, Hepatopancreatobiliary Surgery Unit, Medicine Faculty of İstanbul, İstanbul, Turkey.



Definitive treatment of traumatic biliary injuries

Mert Erkan1, Orhan Bilge1, İlgin Özden1, Yaman Tekant1, Koray Acarlı1, Aydın Alper1, Ali Emre1, Orhan Arıoğul1
Department of General Surgery, Hepatopancreatobiliary Surgery Unit, Medicine Faculty of İstanbul, İstanbul, Turkey.

BACKGROUND: We presented our experience with definitive treatment of traumatic biliary injuries. METHODS: Six male patients (mean age 13 years; range 2 to 32 years) who were referred to our unit for definitive treatment of traumatic biliary injuries were retrospectively evaluated. Data were analyzed in terms of demographic characteristics, echanisms of injuries, associated injuries, previous treatments, symptoms on admission, treatment at our unit, and the results of treatment. Outcome was assessed using modified Schweiser and Blumgart criteria. RESULTS: The injuries were due to blunt abdominal trauma in all the patients but one who had a gunshot wound. In three patients, biliary injuries were missed at the initial operation. On admission, three patients had external biliary fistulas, two had biliary strictures. One patient was sent following inadvertent ligation of the hepatoduodenal ligament during attempts to control hemorrhage. Roux-en-Y hepaticojejunostomy was performed in three patients. Percutaneous biloma drainage was performed in two patients, esulting in fistula closure in 13 and 40 days, respectively. One patient was treated by endoscopic retrograde cholangiopancreatography and papillotomy, which enabled fistula closure
in three days. One patient was lost to follow-up. One patient died from hepatic failure 11 years after the trauma. At the end of a mean follow-up of 49 months (range 15 to 75 months), three patients were in excellent condition, while one patient experienced occasional attacks of cholangitis. CONCLUSION: In patients with undetected biliary injuries and in those with unsuccessful repair attempts, biliary reconstruction should be performed in experienced hepatopancreatobiliary surgery units.



Mert Erkan, Orhan Bilge, İlgin Özden, Yaman Tekant, Koray Acarlı, Aydın Alper, Ali Emre, Orhan Arıoğul. Definitive treatment of traumatic biliary injuries. Ulus Travma Acil Cerrahi Derg. 2004; 10(4): 221-225


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