TY - JOUR ID - 99995 TI - Temporary Trans-jejunal Hepatic Duct Stenting in Roux-en-y Hepaticojejunostomy for Reconstruction of Iatrogenic Bile Duct Injuries JO - Trauma Monthly JA - TM LA - en SN - 2251-7464 AU - Fazeli, Mohammad Sadegh AU - Kazemeini, Ali Reza AU - Jafarian, Ali AU - Bashashati, Mohammad AU - Keramati, Mohammad Reza AD - Y1 - 2016 PY - 2016 VL - 21 IS - 2 SP - EP - KW - biliary tract KW - Reconstruction KW - Treatment outcome KW - bile duct KW - Iatrogenic DO - 10.5812/traumamon.21115 N2 - Background: Bile Duct Injuries (BDI) during cholecystectomy are now being recognized as major health problems. Objectives: Herein, we present our experience with handling major BDIs and report long-term outcome of hepaticojejunostomies followed by trans-jejunal hepatic duct stenting performed to reconstruct extra-hepatic biliary tracts. Materials and Methods: In this case series, we prospectively collected data of 22 patients, who underwent first time biliary reconstruction through Roux-en-y hepaticojejunostomy followed by hepatic duct stenting using a trans-jejunal bifurcated 6F tube drain. The long-term outcome was assessed and defined as excellent (asymptomatic, normal liver enzymes and bilirubin levels), good (asymptomatic, mild abnormality in liver enzyme and bilirubin levels), poor (symptomatic, abnormal liver enzymes and bilirubin level) and failure (requiring reoperation). Results: A total of 22 patients including four males (18.1%) and 18 females (81.8%) were evaluated. The mean age was 42.71 (range: 23 - 74) years. Twelve patients had undergone open cholecystectomy (54.5%) and the rest had a history of laparoscopic cholecystectomy. The mean interval between the primary operation and reconstruction was 92.71 days. The mean follow-up period after biliary reconstruction was 42.33 (range: 1 - 96) months. No instance of anastomotic leakage or stenosis, biliary sepsis, thromboembolic event, or respiratory infection was noted in the long-term follow-up. The outcome was excellent in all patients. No case with poor or failure of result was noticed. Conclusions: Although a devastating complication iatrogenic major bile duct injuries can be corrected surgically with a high rate of success. Temporary trans-jejunal stenting of the hepatic ducts can help in maintaining the integrity of anastomosis without stenosis or biliary sepsis. UR - https://www.traumamon.com/article_99995.html L1 - https://www.traumamon.com/article_99995_23170767b2243f147fec78c497fa7f82.pdf ER -