Resumen

PEREIRA GRATEROL, Freddy; VENALES B, Yajaira  y  SALAZAR MARCANO, Francisco. Right hepatic bile duct injury: a single stage combined laparoscopic-endoscopic treatment. Rev. gastroenterol. Perú [online]. 2020, vol.40, n.1, pp.85-88. ISSN 1022-5129.

Treatment of bile ducts injuries (BDI) treatment, combining minimally access surgical techniques, although their benefits, has been scarcely reported. We described a combined laparoscopic-endoscopic procedure, carried out in a patient with postoperative right hepatic duct (RHD) injury associated to laparoscopic cholecystectomy. Based on a clinical case description, we illustrate the surgical technique and assess their applicability and results. A biliary fistula was identified employing laparoscopic cholangiography and a metallic clip applied, producing RHD occlusion, was retrieved under fluoroscopic guidance. A biliary "rendezvous" maneuver was done for positioning an endoscopic biliary stent. The biliary fistula disappeared within two weeks and during 40-months of follow-up the patient remains asymptomatic. Laparoscopic-endoscopic approach, although technically demanding, resulted effective to treat this patient. A Continuous follow-up is essential for evaluating the long-term results.

Palabras clave : Injuries, surgical; Bile ducts; Biliary fistula; Cholangiopancreatography, endoscopic retrograde.

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