CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S11-S12
DOI: 10.1055/s-0041-1730677
Abstract

Difficulties and Challenging Cases in Radiological Intervention Management of Postcholecystectomy Biliary Injury and Posthepaticojejunostomy Complications: More Than 20 Years' Experience from Tertiary Care Centers

Abd El-Salam Abd El-Aziz Abd El-Aziz
Faculty of Medicine, Assiut University, Assiut, Egypt, Saudi Arabia
,
Iyad M Subei
Faculty of Medicine, Assiut University, Assiut, Egypt, Saudi Arabia
,
Ji Hoon Shin
Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
,
Hany Mohamed Abdel-Hakim Saif
Faculty of Medicine, Assiut University, Assiut, Egypt, Saudi Arabia
› Author Affiliations

Background: In the late 1980s after the first successful laparoscopic cholecystectomy in Europe, this minimally invasive surgery rapidly became the accepted technique for the treatment of gallbladder disease in the United States of America. The rapid acceptance of this new technique by the medical profession and the public was related to the obvious advantages of reduced cost, decreased hospital length of stay, and increased patients' satisfaction (Nezam H Afdhal et al., 2017). Common bile duct (CBD) injuries are the most serious and feared complications of laparoscopic cholecystectomy since they cause substantial morbidity and increased hospital stay and increasingly often are the subject of legal disputes (Chir Ital., 2007). Recommendation, according to the last update as well known in the literatures, for the management of complications of cholecystectomy in biliary duct injuries should always be approached by an experienced multidisciplinary team consisting of surgeons, interventional gastroenterologists, and interventional radiologists. Methods: Patients presented at any time with different types of postcholecystectomy biliary injury and posthepaticojejunostomy complications were subjected to intervention radiological procedures with and/or without endoscopic-radiologic rendezvous. Results: We succeeded to manage 840 cases of postcholecystectomy biliary injury (783 cases) and posthepaticojejunostomy complications (57 cases) by percutaneous transhepatic biliary access, throughout more than 20 years starting in October 1995 when we had established the 1st intervention unit in upper Egypt, at Assiut University Hospital, and lately in other institutional centers in the Kingdom of Saudi Arabia. Conclusion: Biliary injuries or complications, following cholecystectomy or postcholecystectomy, usually can be treated within tertiary referral hepatobiliary multidisciplinary center, and major surgery can be avoided and performed only in selective conditions.



Publication History

Article published online:
11 May 2021

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