Reconstrucción de lesiones de la vía biliar principal: La evolución hacia la técnica de Hepp-Couinaud

Abstract

Background: Bile duct injury (BDI) is a complex problem, where adequate reconstruction has an impact on quality of life of patients. Aim: To describe the experience and results of bile duct reconstruction in BDI at reference center. Material and Methods: Retrospective review of 25 patients aged 44 ± 14 (76% females) with BDI that were subjected to a surgical repair in a regional hospital between January 2000 and June 2009. The protocol, repair technique and postoperative morbidity and mortality are described. Results: In 40% of cases, the injury occurred during laparoscopic cholecystectomy. The repair was performed using a Roux-en-Y hepato-jejunostomy (RYHJ) in 20 patients. In 14 patients (70%), the modified Hepp-Couinaud technique was used. Thirty two percent of patients had postoperative complications and one patient died due to a sepsis and liver failure. One patient presented RYHJ stenosis that was managed with percutaneous dilatation. Conclusions: The majority of patients of this series were managed using a RYHJ with the Hepp-Couinaud technique, with acceptable results in terms of postoperative morbidity and stenosis.