Bile Duct Injuries with Loss of Confluence

Oscar Chapa-Azuela; Alejandro José Rosales; Carmen Roca-Vasquez; Brenda Arcos-Vera; Jorge Alberto Roldan-Garcia; Gustavo Alain Flores-Rangel

doi:doi:10.11648/j.ijg.20180201.12

Bile Duct Injuries with Loss of Confluence

Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Brenda Arcos-Vera, Jorge Alberto Roldan-Garcia, Gustavo Alain Flores-Rangel

Published in International Journal of Gastroenterology (Volume 2, Issue 1)

Received: 12 April 2018 Accepted: 10 May 2018 Published: 30 May 2018

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Abstract

Introduction: Iatrogenic bile duct injuries (IBDI) with loss of confluence are understood as those where right and left hepatic ducts lose continuity with the common biliary tree. These represent 4% of all IBDI and are considered a very demanding surgical challenge. Study design: This is a series of case in a reference center during an eight-year period (2008 – 2016), where all patients with IBDI and loss of confluence submitted to any bilioenteric derivation procedure were included. Results: From a total of 11 cases, 10 of them (90.1%) were treated with double bilioenteric derivation and 1 (9%) with a neo-confluence. In 90.9% (n=10) of the patients a percutaneous catheter of biliary drainage was placed before the surgical procedure. Within a 34.5 months follow-up, the initial approach was successful in 54.5% (n=6), meanwhile accumulated achievement was 81.8% (n=9) considering dilatation and remodeling procedures. From this, 18.2% (n=2) are still with stenosis of derivation in a dilatation protocol with percutaneous catheter. Conclusions: Double hepatojejunostomy with transanastomotic stents and management of eventual stenosis with percutaneous dilatation as a first therapeutic intention results in a standardized practice that leads to reasonable results compared with other high volume centers.

Published in	International Journal of Gastroenterology (Volume 2, Issue 1)
DOI	10.11648/j.ijg.20180201.12
Page(s)	7-11
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Lesion, Bile, Loss, Confluence

References

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APA Style

Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Brenda Arcos-Vera, Jorge Alberto Roldan-Garcia, et al. (2018). Bile Duct Injuries with Loss of Confluence. International Journal of Gastroenterology, 2(1), 7-11. https://doi.org/10.11648/j.ijg.20180201.12

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ACS Style

Oscar Chapa-Azuela; Alejandro José Rosales; Carmen Roca-Vasquez; Brenda Arcos-Vera; Jorge Alberto Roldan-Garcia, et al. Bile Duct Injuries with Loss of Confluence. Int. J. Gastroenterol. 2018, 2(1), 7-11. doi: 10.11648/j.ijg.20180201.12

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AMA Style

Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Brenda Arcos-Vera, Jorge Alberto Roldan-Garcia, et al. Bile Duct Injuries with Loss of Confluence. Int J Gastroenterol. 2018;2(1):7-11. doi: 10.11648/j.ijg.20180201.12

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@article{10.11648/j.ijg.20180201.12,
  author = {Oscar Chapa-Azuela and Alejandro José Rosales and Carmen Roca-Vasquez and Brenda Arcos-Vera and Jorge Alberto Roldan-Garcia and Gustavo Alain Flores-Rangel},
  title = {Bile Duct Injuries with Loss of Confluence},
  journal = {International Journal of Gastroenterology},
  volume = {2},
  number = {1},
  pages = {7-11},
  doi = {10.11648/j.ijg.20180201.12},
  url = {https://doi.org/10.11648/j.ijg.20180201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20180201.12},
  abstract = {Introduction: Iatrogenic bile duct injuries (IBDI) with loss of confluence are understood as those where right and left hepatic ducts lose continuity with the common biliary tree. These represent 4% of all IBDI and are considered a very demanding surgical challenge. Study design: This is a series of case in a reference center during an eight-year period (2008 – 2016), where all patients with IBDI and loss of confluence submitted to any bilioenteric derivation procedure were included. Results: From a total of 11 cases, 10 of them (90.1%) were treated with double bilioenteric derivation and 1 (9%) with a neo-confluence. In 90.9% (n=10) of the patients a percutaneous catheter of biliary drainage was placed before the surgical procedure. Within a 34.5 months follow-up, the initial approach was successful in 54.5% (n=6), meanwhile accumulated achievement was 81.8% (n=9) considering dilatation and remodeling procedures. From this, 18.2% (n=2) are still with stenosis of derivation in a dilatation protocol with percutaneous catheter. Conclusions: Double hepatojejunostomy with transanastomotic stents and management of eventual stenosis with percutaneous dilatation as a first therapeutic intention results in a standardized practice that leads to reasonable results compared with other high volume centers.},
 year = {2018}
}

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TY  - JOUR
T1  - Bile Duct Injuries with Loss of Confluence
AU  - Oscar Chapa-Azuela
AU  - Alejandro José Rosales
AU  - Carmen Roca-Vasquez
AU  - Brenda Arcos-Vera
AU  - Jorge Alberto Roldan-Garcia
AU  - Gustavo Alain Flores-Rangel
Y1  - 2018/05/30
PY  - 2018
N1  - https://doi.org/10.11648/j.ijg.20180201.12
DO  - 10.11648/j.ijg.20180201.12
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 7
EP  - 11
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20180201.12
AB  - Introduction: Iatrogenic bile duct injuries (IBDI) with loss of confluence are understood as those where right and left hepatic ducts lose continuity with the common biliary tree. These represent 4% of all IBDI and are considered a very demanding surgical challenge. Study design: This is a series of case in a reference center during an eight-year period (2008 – 2016), where all patients with IBDI and loss of confluence submitted to any bilioenteric derivation procedure were included. Results: From a total of 11 cases, 10 of them (90.1%) were treated with double bilioenteric derivation and 1 (9%) with a neo-confluence. In 90.9% (n=10) of the patients a percutaneous catheter of biliary drainage was placed before the surgical procedure. Within a 34.5 months follow-up, the initial approach was successful in 54.5% (n=6), meanwhile accumulated achievement was 81.8% (n=9) considering dilatation and remodeling procedures. From this, 18.2% (n=2) are still with stenosis of derivation in a dilatation protocol with percutaneous catheter. Conclusions: Double hepatojejunostomy with transanastomotic stents and management of eventual stenosis with percutaneous dilatation as a first therapeutic intention results in a standardized practice that leads to reasonable results compared with other high volume centers.
VL  - 2
IS  - 1
ER  -

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Author Information

Oscar Chapa-Azuela

General Hospital of México, Mexico City, México
Alejandro José Rosales

General Hospital of México, Mexico City, México
Carmen Roca-Vasquez

General Hospital of México, Mexico City, México
Brenda Arcos-Vera

Issemym Toluca Medical Center, Toluca, Mexico
Jorge Alberto Roldan-Garcia

General Hospital of México, Mexico City, México
Gustavo Alain Flores-Rangel

General Hospital of México, Mexico City, México

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APA Style

Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Brenda Arcos-Vera, Jorge Alberto Roldan-Garcia, et al. (2018). Bile Duct Injuries with Loss of Confluence. International Journal of Gastroenterology, 2(1), 7-11. https://doi.org/10.11648/j.ijg.20180201.12

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ACS Style

Oscar Chapa-Azuela; Alejandro José Rosales; Carmen Roca-Vasquez; Brenda Arcos-Vera; Jorge Alberto Roldan-Garcia, et al. Bile Duct Injuries with Loss of Confluence. Int. J. Gastroenterol. 2018, 2(1), 7-11. doi: 10.11648/j.ijg.20180201.12

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AMA Style

Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Brenda Arcos-Vera, Jorge Alberto Roldan-Garcia, et al. Bile Duct Injuries with Loss of Confluence. Int J Gastroenterol. 2018;2(1):7-11. doi: 10.11648/j.ijg.20180201.12

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@article{10.11648/j.ijg.20180201.12,
  author = {Oscar Chapa-Azuela and Alejandro José Rosales and Carmen Roca-Vasquez and Brenda Arcos-Vera and Jorge Alberto Roldan-Garcia and Gustavo Alain Flores-Rangel},
  title = {Bile Duct Injuries with Loss of Confluence},
  journal = {International Journal of Gastroenterology},
  volume = {2},
  number = {1},
  pages = {7-11},
  doi = {10.11648/j.ijg.20180201.12},
  url = {https://doi.org/10.11648/j.ijg.20180201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20180201.12},
  abstract = {Introduction: Iatrogenic bile duct injuries (IBDI) with loss of confluence are understood as those where right and left hepatic ducts lose continuity with the common biliary tree. These represent 4% of all IBDI and are considered a very demanding surgical challenge. Study design: This is a series of case in a reference center during an eight-year period (2008 – 2016), where all patients with IBDI and loss of confluence submitted to any bilioenteric derivation procedure were included. Results: From a total of 11 cases, 10 of them (90.1%) were treated with double bilioenteric derivation and 1 (9%) with a neo-confluence. In 90.9% (n=10) of the patients a percutaneous catheter of biliary drainage was placed before the surgical procedure. Within a 34.5 months follow-up, the initial approach was successful in 54.5% (n=6), meanwhile accumulated achievement was 81.8% (n=9) considering dilatation and remodeling procedures. From this, 18.2% (n=2) are still with stenosis of derivation in a dilatation protocol with percutaneous catheter. Conclusions: Double hepatojejunostomy with transanastomotic stents and management of eventual stenosis with percutaneous dilatation as a first therapeutic intention results in a standardized practice that leads to reasonable results compared with other high volume centers.},
 year = {2018}
}

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TY  - JOUR
T1  - Bile Duct Injuries with Loss of Confluence
AU  - Oscar Chapa-Azuela
AU  - Alejandro José Rosales
AU  - Carmen Roca-Vasquez
AU  - Brenda Arcos-Vera
AU  - Jorge Alberto Roldan-Garcia
AU  - Gustavo Alain Flores-Rangel
Y1  - 2018/05/30
PY  - 2018
N1  - https://doi.org/10.11648/j.ijg.20180201.12
DO  - 10.11648/j.ijg.20180201.12
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 7
EP  - 11
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20180201.12
AB  - Introduction: Iatrogenic bile duct injuries (IBDI) with loss of confluence are understood as those where right and left hepatic ducts lose continuity with the common biliary tree. These represent 4% of all IBDI and are considered a very demanding surgical challenge. Study design: This is a series of case in a reference center during an eight-year period (2008 – 2016), where all patients with IBDI and loss of confluence submitted to any bilioenteric derivation procedure were included. Results: From a total of 11 cases, 10 of them (90.1%) were treated with double bilioenteric derivation and 1 (9%) with a neo-confluence. In 90.9% (n=10) of the patients a percutaneous catheter of biliary drainage was placed before the surgical procedure. Within a 34.5 months follow-up, the initial approach was successful in 54.5% (n=6), meanwhile accumulated achievement was 81.8% (n=9) considering dilatation and remodeling procedures. From this, 18.2% (n=2) are still with stenosis of derivation in a dilatation protocol with percutaneous catheter. Conclusions: Double hepatojejunostomy with transanastomotic stents and management of eventual stenosis with percutaneous dilatation as a first therapeutic intention results in a standardized practice that leads to reasonable results compared with other high volume centers.
VL  - 2
IS  - 1
ER  -

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