Patients and methods. Twenty-nine surgical procedures were carried out in 24 patients to repair bile duct lesions that developed after OC (n = 12) or LC (n = 12). Most of the patients had undergone Roux-en-Y hepaticojejunostomy with a subcutaneous port to allow subsequent percutaneous dilatation.
Results. The onset of lesions associated with LC occurred significantly sooner, accompanied by biliary fistula, in comparison with post-OC lesions which presented with jaundice 12 months after the original surgical procedure. We recorded a rate of stenosis of 20% following Roux-en-Y hepaticojejunostomy, but when accompanied by percutaneous dilatations via the subcutaneous port, the rate of success was 85%. The patients who were referred directly to our unit underwent an average of 1 surgical procedure (range: 1 to 4) in comparison with 3 (range: 2 to 10) among those who received some kind of treatment at their hospital of origin (p = 0.02).
Conclusions.. We observe different patterns of presentation of bile duct injury after OC and LC. These lesions are associated with an elevated incidence of complications and restenosis; thus, we recommend the construction of a subcutaneous port using the afferent arm of the Roux-en-Y to allow subsequent dilatation.