2 . 2023

Robotic reconstruction of bile ducts after iatrogenic injury

Abstract

Hepaticojejunostomy remained the best treatment in patients with major bile duct injury during laparoscopic cholecystectomy. But the number of postoperative strictures is still high. Therefore, improving the technique of hepaticojejunostomy is still relevant.

Material and methods. The results of laparoscopic robot-assisted hepaticojejunostomy using the da Vinci Si surgical system performed in 3 patients with iatrogenic injury of the common bile duct as a result of unsuccessful laparoscopic cholecystectomy are presented.

Results. All patients had iatrogenic damage of the common bile duct in other clinics during laparoscopic cholecystectomy for complicated acute cholecystitis. Therefore, more than 6 weeks after the first intervention was chosen for reconstruction in order to completely stop the inflammatory process. The criteria for patency of hepaticojejuanastomosis were the absence of cholangitis, jaundice, biliary fistula, stenting, percutaneous transhepatic drainage and re-surgical reconstructive surgery within at least 90 days after operation.

Conclusion. Laparoscopic robot-assisted hepaticojejunostomy is a safe and effective approach for iatrogenic bile duct injury. More observations are required to study early and late postoperative complications.

Keywords:bile duct injury; laparoscopic hepaticoejunostomy; robotic hepaticoejunostomy; anastomosis stricture; bile leakage

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Timerbulatov M.V., Grishina E.E., Aziev M.M., Ziganshin T.M. Robotic reconstruction of bile ducts after iatrogenic injury. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (2): 41–7. DOI: https://doi.org/10.33029/2308-1198-2023-11-2-41-47 (in Russian)

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