Akademik Veri Yönetim Sistemi
LANGENBECKS ARCHIVES OF SURGERY, cilt.388, sa.4, ss.265-269, 2003 (SCI-Expanded)
Background and aims. To evaluate treatment results in iatrogenic biliary injuries with concomitant vascular injuries. Patients/Methods. Between January 1998 and May 2002 (inclusive), angiography was performed in 45 of the 105 patients treated for iatrogenic biliary tract injury. The charts of these 45 patients and 5 other patients in whom vascular injury was diagnosed at operation were evaluated retrospectively. Twenty-nine patients had concomitant vascular injury, the biliovascular injury group (BVI), and the remaining 21 patients had isolated biliary tract injury (IBTI). Results. The most frequent initial operation was a cholecystectomy. The frequency of high-level (Bismuth III or IV) strictures was 90% in the BVI group and 62% in the IBTI group (P<0.05). Perioperative mortality was 7% in the BVI group and 5% in the IBTI group (P>0.05). The morbidity in the BVI group was significantly higher (P<0.05). Two patients in each group were lost to follow up. During a median (range) follow up of 31 months (5-51 months), a successful functional outcome was achieved in 96% of the BVI group and 100% of the IBTI group with a multimodal approach (P>0.05). Conclusions. The frequency of high-level biliary injury and morbidity were significantly higher in the BVI group. However, concomitant vascular injury had no significant effect on mortality and medium-term outcome of biliary reconstruction. Thus, routine preoperative angiography is not recommended.