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PDF files are usually the right choice for those whose computers can not open word. The books also introduce you to new words and sentences. (For example, if you can’t work.Ostic dilation in the management of bile duct injury during cholecystectomy: a critical review.
Bile duct injury during cholecystectomy is associated with a high morbidity and mortality rate. Surgical repair is the first choice of treatment. The management of bile duct injuries, however, is controversial. Although biliary stricture occurs in approximately 50% of patients with bile duct injury, ostic stricture is rare. In this article, we discuss the management of bile duct injury and review our experience in the use of ostic dilatation as an alternative to surgical repair. Between 2000 and 2008, of 171 patients that underwent cholecystectomy, 11 patients (6.4%) had an isolated bile duct injury. Of these 11 patients, six patients (54.5%) underwent surgical repair of the bile duct injury. Seven patients (63.6%) were managed conservatively by otic stricture dilatation. Mean stricture length and diameter of the ostic duct were 6.5 mm (range, 3 to 12) and 20 mm (range, 16 to 23), respectively. An increase in median stricture length by at least 1.4 mm from the immediate postoperative period was associated with a 0% stricture recurrence rate at 3 months (p=0.016) and a median stricture length of 10 mm at 3 months (p=0.001). The median stricture length was 20 mm at 6 months. Median stricture diameters of the common bile duct and common hepatic duct were 6 mm (range, 4 to 8) and 8 mm (range, 7 to 10), respectively. A ratio of common bile duct to common hepatic duct stricture length of 0.8 may be used to help prevent biliary stricture recurrence.Former
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