Evaluation Of Permanent Duodenal Access Loop In Treatment Of Iatrogenic Bile Ducts Injuries, Comparative Study.

[摘要] Latrogenic bile duct injuries are surgically treated with ROUX en Y hepaticojejunostomy but,complications as biliary-enteric anastomosis stricture, intrahepatic stones, and recurrent cholangitis are notuncommon, radiological interventional techniques for dilatation of the stricture and stone extraction are notsuccessful in all patients, it needs a special facilities and expertise, the need for an access loop emerged tomake use of the availability of ERCP and its therapeutic applications. A comparative study between twogroups, group I; retrospective group, 21 patients underwent hepaticojejunostomy for treatment of iatrogenicbile duct injuries without access loop, in the period between January 2013 and December 2014, group II; aprospective group, 23 patients underwent hepaticojejunostomy for iatrogenic bile duct injuries withduodenojejunostomy as a permanent access loop, in the period between June 2017 and May 2019. Primary(early and late outcome) and management of complications data were collected and analyzed properly.Jaundice, pain and cholangitis are the main presentations, BDI occurred mostly post laparoscopiccholecystectomy, and Bismuth II level was the most common injury pattern, biliary stricture complicated 4cases in group I and 3 cases in group II, incisional hernia occurred in 2 cases of each group, 2ry biliary cirrhosiscomplicated two cases of group I. Management of biliary enteric anastomotic stricture shows significantdifference in favor of access loop group, as in group Iwe performedredo surgery in 3 of the4 cases, in groupII the 3 cases were managed successfully by ERCP balloon dilatation through the access loop. ROUX en Yhepaticojejunostomy with permanent duodenojejunostomy access loop is better in management of biliaryenteric anastomotic complications without any need for surgical intervention.

[学科分类] 工程和技术（综合）

[关键词] Bile duct injuries;access loop;duodenojejunostomy;hepaticojejunostomy