Диагностика и современная тактика хирургического лечения ятрогенных травм внепеченочных желчных протоков и наружных желчных свищей

Аннотация

The article presents the analysis of surgical treatment of 317 patients with intraoperation damage and external fistulas of the extrahepatic bile-ducts. The reasoning formation of strictures and external biliary fistulas was intraoperative damage during cholecystectomy, gastric resection and echinococcectomy. Preoperatively all the patients underwent correction of violations of water-electrolyte balance, treatment and prevention of hepatic-renal failure, the fight against anaerobic infection. From 317 patients 29 (9.1 %) - restorative and 288 (90.9 %) reconstructive operations were performed. Stricture recurrence that required repeat surgical intervention was marked in 21 (6.7%) of patients. Various postoperative complications observed in 63 (19.8 %). Mortality was 8.7 %. The main cause of death – intoxication, renal failure, associated with suppurative cholangitis and cholangiolitis abscesses of the liver due to insolvency of anastomosis seams