Shevchuk B. Diagnosis and surgical treatment of combined injuries extrahepatic bile ducts and vessels during cholecystectomy

The work is based on the integrated clinical examination and surgical treatment of 56 patients with iatrogenic bile duct injuries during open and laparoscopic cholecystectomy. Among them were 26 patients with combined bile duct's injury and hepatic artery branches and 30 patients with isolated complete bile duct damage.The presence and nature of complications associated with liver ischemia, needed an individual approach to the surgical treatment. In patients with isolated bile duct's injuries the main method of operation was high hepaticojejunostomy. In patients with combined bile duct's and hepatic artery branches injuries, in addition, were performed operations for revascularization of hepar and liver resection of different volume. Application of multimodal treatment in patients with combined bile duct injuries and branches of the hepatic artery during cholecystectomy can obtain the positive results in 84.6% of observations.