Fundamentals of Bile Duct Injuries: From Prevention to Multidisciplinary Management

162 Pages·2022·6.941 MB·English

by  Juan Pekolj, Victoria Ardiles, Juan Glinka

Fundamentals
of Bile Duct
Injuries
From Prevention
to Multidisciplinary
Management
Juan Pekolj
Victoria Ardiles
Juan Glinka
Editors
123
Fundamentals of Bile Duct Injuries
Juan Pekolj • Victoria Ardiles • Juan Glinka
Editors
Fundamentals of Bile
Duct Injuries
From Prevention to Multidisciplinary
Management
Editors
Juan Pekolj Victoria Ardiles
General Surgery Service & Liver General Surgery & Liver Transplant Unit
Transplant Unit Hospital Italiano de Buenos Aires
Buenos Aires, Buenos Aires, Argentina Buenos Aires, Buenos Aires, Argentina
Juan Glinka
HPB Surgery; Multi-Organ Transplantation
Western University
London, ON, Canada
ISBN 978-3-031-13382-4 ISBN 978-3-031-13383-1 (eBook)
https://doi.org/10.1007/978-3-031-13383-1
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
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To all the previous members of the HPB
Surgery Section of the General Surgery
Service of Hospital Italiano de Buenos Aires
Argentina
To my mentors Dr. Enrique Marcelo
Beveraggi and Dr. Eduardo de Santibañes
To my daughters Tatiana, Milenka, and
Ivana, my anchor in the life.
Juan Pekolj
To my husband, Arturo, and my children,
Felipe, Francisco, and Emilia.
To my mentor, Dr. Eduardo de Santibañes for
his permanent guidance, inspiration, and
support.
Victoria Ardiles
In memory of my beloved mother, Odilia.
To the apple of my eyes, Florencia and
Carmela.
My little “warrior hearts” brothers, Vladimir
and Jeremias.
To Eduardo de Santibañes, Ernesto Molmenti
and Ephraim Tang for their permanent
support and inspiration.
And to the co-editors Juan Pekolj and
Victoria Ardiles for the immense privilege of
working with them in this project.
Juan Glinka
Epilogue
Bile duct injuries (BDI) are still an important complication of cholecystectomy,
either open or laparoscopic. Nowadays, after 35 years from the first laparoscopic
cholecystectomy, BDI are still the Achille’s heel of this approach.
BDI is a topic of great concern for surgeons, due to the life risk and unpredictable
results on the patient, and the potential litigation with the physical and mental con-
sequences for the surgeon (“second victim”).
The consensus about the management of a BDI, must be done in a referent center
by means of a multidisciplinary approach. The spectrum of treatment for these
patients is so wide, from a percutaneous abdominal drainage to a liver transplanta-
tion, and in the middle of multiple different options.
The Section of Hepato-Pancreato-Biliary (HPB) Surgery, in the General Surgery
Service from the Hospital Italiano de Buenos Aires in Argentina was created in the
year 1974. Since that moment, the team was a referent group in the country and in
South America for the management of BDI. Also, we perform close to 700 LC per
year, and this allows us, with our own BDI, to understand the mechanism and intra-
operative diagnose and propose algorithms for the management in this crucial
moment. Our section is very well trained in BDI repair, liver resection, and liver
transplantation.
Our hospital also has a very developed Image Service, Gastroenterology and
Endoscopy Service, Critical Care Service, and a Biliary Multidisciplinary Team,
making our institution as an ideal place for treating BDI.
The objective of this book is to give a simple and useful publication, easy to
apply in daily activities, and to publish our experience in the different topics of the
management of BDI.
Our thanks go to all the chapter authors for their time and dedication giving clear
messages and to our General Surgery Service and its members and our Hospital
vii
viii Epilogue
Italiano de Buenos Aires for allowing us to grow without limits. A special thanks go
to Springer Editorial for their trust in our project and helping us in the process of
developing this book.
Juan Pekolj, MD, PhD
Victoria Ardiles, MD, PhD
Juan Glinka, MD
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Juan Pekolj
2 Anatomical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Martín de Santibañes and Eduardo de Santibañes
3 Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Juan Pekolj
4 Essential Aspects BDI Management . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Oscar Mazza and Marcos Zandomeni
5 Physiopathology of BDI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Martin Palavecino
6 Classification of BDI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
David Alberto Biagiola, Ignacio Merlo, Juan Glinka,
and Rodrigo Sanchez Cláriá
7 Intraoperative Diagnosis and Treatment . . . . . . . . . . . . . . . . . . . . . . . 51
Martin Palavecino
8 Postoperative Diagnosis of BDI’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Victoria Ardiles and David Alberto Biagiola
9 Role of Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Juan Carlos Spina and Ramiro Orta
10 Assessment of Vascular Structures in BDI’s . . . . . . . . . . . . . . . . . . . . . 79
David Alberto Biagiola and Martín de Santibañes
11 Postoperative Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Ignacio Fuente and Martín de Santibañes
12 The Role of Percutaneous Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Sung Ho Hyon and Pablo Huespe
ix
x Contents
13 Role of Endoscopic Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Carlos Macías Gómez and Federico Marcaccio
14 Role of Minimally Invasive Surgery (MIS) . . . . . . . . . . . . . . . . . . . . . . 119
Jeremias Goransky and Guillermo Arbues
15 Biliodigestive Anastomosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
David Alberto Biagiola, Juan Glinka, and Rodrigo Sánchez Claria
16 Liver Resections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Julio César Lazarte and Juan Pekolj
17 Liver Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Juan Glinka, Eduardo de Santibañes, and Victoria Ardiles
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159