Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 11 , ISSUE 2 ( May-August, 2022 ) > List of Articles

Original Article

Experiencia en reparaciones de lesión de vía biliar en un servicio de urgencia en el Hospital General San Juan de Dios

Claudia Alejnadra Anton, Napoleon Mendez, Mario Andrés Flores, Rudy Alejandro Herrera

Keywords : Bile duct, Cholecystectomy, Injury

Citation Information : Anton CA, Mendez N, Flores MA, Herrera RA. Experiencia en reparaciones de lesión de vía biliar en un servicio de urgencia en el Hospital General San Juan de Dios. Panam J Trauma Crit Care Emerg Surg 2022; 11 (2):78-81.

DOI: 10.5005/jp-journals-10030-1388

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: The objective of this study is to describe the experience in the management of surgical injury of the bile duct in an emergency service in a Latin American country with limited resources. The study also epidemiologically characterizes the type of injuries that were managed and their evolution. Biliary tract injuries represent an infrequent complication; the bibliography on the matter is little because the world's casuistry is limited. Materials and methods: A retrospective, descriptive, and observational cross-sectional study of patients with surgical bile duct injury treated in the emergency department and who were operated on at Hospital General San Juan de Dios with bile duct injuries between the years 2019 and April 2021. Results: A total of seven cases are described, with a mean age of 32.6 years, and 86% are female. Of the seven patients, five (71%) were injuries referred from other hospitals in Guatemala, and 86% were due to open cholecystectomy. Intraoperative diagnosis was given only in two cases where biliodigestive surgery was performed at the same surgical time. Six patients had a Bismuth II type of injury, and one had a Bismuth I injury. All seven patients underwent Roux-en-Y hepatojejunal anastomosis. Mortality was two cases due to intra-abdominal sepsis. One of the cases underwent reoperation 7 months later due to 100% stenosis of the hepatojejunal anastomosis. Conclusion: This study describes the experience of the surgical emergency service of the Hospital General San Juan de Dios in treating injuries of the bile ducts. The hospital is a national reference center, and despite limited resources, most patients with postcholecystectomy injuries are admitted for diagnosis and surgical treatment. The hospital has extensive experience in the management of biliary tract injuries. Our experience shows a predominance of the female sex, that early diagnoses had a better success rate, while late diagnoses have a connection with significant mortality.

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