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Angel Joel Maldonado Velazquez

Angel Joel Maldonado Velazquez

UNAM, Mexico

Title: Percutaneous management of postsurgical complications of the bile duct

Biography

Biography: Angel Joel Maldonado Velazquez

Abstract

Objective: To present the results obtained in 273 patients treated in the Department of Vascular and Surgical Radiology of the Hospital General de Mexico Radiology and Image Service as a result of post-surgical complications of the bile duct.

Material and Method: Radiological files of all patients with post-surgical bile duct complications treated at the hospital’s Department of Vascular and Surgical Radiology over a 5-year period were reviewed retrospectively.

Results: In a 5-year period, between January 2007 and December 2011, 273 patients with post-surgical bile duct complications were attended: 209 women (76.6%) and 64 men (23.4%). The complications were: residual lithiasis 158 patients (57.7%); fistula 8 (3%); bile duct lesion 23 (8.5%); biliary lesion without biliodigestive communication 11 (4%); abscess in vesicular bed 1 patient (0.3%); biloma 15 patients (5.5%); stenosis of biliodigestive bypass 57 patients (21%). Percutaneous management consisted of: extraction of bile duct stones with a stone basket in 158 patients; placement of external or mixed biliary bypass catheter depending on pathology, desired image characteristics and outcome in 31 patients; percutaneous biliodigestive traction and fertilization with catheter in 11 patients; drainage and percutaneous catheterization in 16 patients; dilation with balloon of the stenosis site and progressive dilation with biliary bypass catheter, increasing the gage in each replacement, in 57 patients.

Conclusions: Post-surgical complications of the bile duct can be serious and may occur in patients with benign disease, requiring careful and multidisciplinary management by doctors with experience and interest in this kind of case. Surgical management in suitably screened patients has increased as a therapeutic approach due to its advantages: minimal invasion, short recovery time, and ambulatory treatment.