Abstract:
BACKGROUND AND AIMS:Right aberrant hepatic ducts are an anatomic variant with clinical relevance because of the risk of injury during cholecystectomy. Treatment options for aberrant hepatic duct injuries are not standardized. This study aims to analyze the long-term results of endoscopic treatment of aberrant hepatic duct lesions. METHODS:Patients who underwent ERCP for aberrant hepatic duct lesions were retrospectively identified. Demographic data, type of aberrant duct lesion according to the Strasberg classification, type of treatment (number of plastic stents inserted, treatment duration, and number of ERCPs), and adverse events were recorded. Follow-up was obtained by telephone contact or medical examinations. RESULTS:Between January 1996 and March 2019, 32 patients (78% women, mean age 51.7 years) with aberrant hepatic duct injuries underwent ERCP at our Endoscopy Unit. Six patients had Strasberg type B lesions, 11 patients had type C, and 8 patients had type E5, and 7 patients had a stenosis of the aberrant duct. A mean of 3.7 biliary plastic stents per patient were used; mean treatment duration was 6.3 months. All patients with isolated aberrant duct stenosis and 1 of 6 patients (17%) with type B Strasberg lesions achieved patency. Ten of 11 patients (91%) with type C Strasberg lesions achieved duct recanalization. After a mean follow-up of 109.3 ± 61.2 months, 29 of 32 patients (91%) were asymptomatic; 1 underwent surgery for recurrent cholangitis, 1 received a new endoscopic procedure because of cholangitis, and 1 reported episodic biliary colic without an increase in liver function test values and was successfully managed with a low-fat diet. CONCLUSIONS:An endoscopic approach to aberrant hepatic duct lesions after cholecystectomy can be considered an effective first-line therapy.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Tringali A,Massinha P,Schepis T,Landi R,Boškoski I,Perri V,Bove V,Costamagna Gdoi
10.1016/j.gie.2019.09.043subject
Has Abstractpub_date
2020-03-01 00:00:00pages
584-592issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(19)32339-9journal_volume
91pub_type
杂志文章abstract::To date, the major guidelines for the management of implanted cardiac devices during electrosurgical procedures have come from 1 of several major medical societies.These most recent guidelines are from the ACCF/AHA in 2009, a combined consensus statement from the Heart Rhythm Society and the American Society of Anesth...
journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
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pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Gastrointestinal endoscopy
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
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更新日期:2004-11-01 00:00:00