Laparoscopic Surgery Research Papers - Academia.edu (original) (raw)

INTRODUCTION
Operative biliary tract injury (TOVB) is a complication encountered mainly after cholecystectomy (CH), whether laparoscopic (CH-L) or open (CH-O), the incidence of TOVB is close to 2 for 103 CH.
MATERIALS AND METHODS
An analytic study carried out including all patients admitted and treated for TOVB at the hepatobiliary surgery and liver transplant department of EHU-1 November 1954, Oran, from January 2010 to May 2018. The objectives were: the study of the epidemiological characteristics of patients, the description of the factors favoring the occurrence of TOVB, the description of the anatomic lesions caused by TOVB, and the analysis of the postoperative morbidity and mortality of patients receiving biliary repair for TOVB.
RESULTS
During this period, 63 patients were admitted for TOVB, the sex ratio was 0.23 with an average age of 45.52 ± 14.02, TOVB was due to CH-L in 50.8%, CH-O in 39.7%, common bile duct lithiasis in 3.2%, liver hydatid cyst surgery in 3.2% and surgery for gallbladder cancer at 3.2%. More than 36% of our patients had undergone a repair before reference and
14.3% were urgently treated at admission for intraperitoneal biliary collection. The most important contributing factor found was acute cholecystitis (42.6%). The biliary lesions were classified according to the "Strasberg" classification, Type A accounted in (3.2%) of the cases,
B (0%), C (3,2%), D (1.6%), E1 (6.3%), E2 (36.3%), E3 (31.7%), E4 (14.3%), E5 (3.2%),
vascular injury was present in 8.8 % of patients. The median repair time was 06 months [0-171 months].
Fifty-seven patients had biliary repair, immediate postoperative mortality was 3.5%, postoperative complications were found in 31.6% of patients, median postoperative stay was 8 days. All of our patients had grade I and grade II repair results according to the Terblanche classification. The mean recoil in our patients was 36.12 ± 25.99 months.
CONCLUSION
The epidemiological characteristics of our patients are similar to those of the international publications, the results of our repairs are good and that would be explained by the respect of the recommendations by our team to ensure a good repair, the low rate of vascular lesion, and the retreat considered to be average. The long repair delay is due to the delay of transfer.