Portal de investigación
Vascular injury during cholecystectomy: A multicenter critical analysis behind the drama.
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Lopez-Lopez, Victor
- Kuemmerli, Christoph
- Cutillas, Jose
- Ramos, Emilio
- Mils, Kristel
- Valdivieso, Andres
- Valero AP
- Martinez PA
- Paterna, Sandra
- Serrablo, Alejando
- Reese, Tim
- Oldhafer, Karl
- Brusadin, Roberto
- Conesa AL
- Valladares LD
- Loinaz, Carmelo
- Garces-Albir, Marina
- Sabater, Luis
- Mocchegiani, Federico
- Vivarelli, Marco
- Pérez SA
- Flores, Benito
- Lucena JL
- Sanchez-Cabus, Santiago
- Calero, Alicia
- Minguillon, Antonio
- Ramia JM
- Alcazar, Candido
- Aguilo, Javier
- Ruiperez-Valiente, Jose A.
- Grochola LF
- Clavien, Pierre-Alain
- Petrowsky, Henrik
- Robles-Campos, Ricardo
Grupos
Abstract
BACKGROUND: The management of a vascular injury during cholecystectomy is still very complicated, especially in centers not specialized in complex hepatobiliary surgery. METHODS: This was a multi-institutional retrospective study in patients with vascular injuries during cholecystectomy from 18 centers in 4 countries. The aim of the study was to analyze the management of vascular injuries focusing on referral, time to perform the repair, and different treatments options outcomes. RESULTS: A total of 104 patients were included. Twenty-nine patients underwent vascular repair (27.9%), 13 (12.5%) liver resection, and 1 liver transplant as a first treatment. Eighty-four (80.4%) vascular and biliary injuries occurred in nonspecialized centers and 45 (53.6%) were immediately transferred. Intraoperative diagnosed injuries were rare in referred patients (18% vs 84%, P = .001). The patients managed at the hospital where the injury occurred had a higher number of reoperations (64% vs 20%, P ? .001). The need for vascular reconstruction was associated with higher mortality (P = .04). Two of the 4 patients transplanted died. CONCLUSION: Vascular lesions during cholecystectomy are a potentially life-threatening complication. Management of referral to specialized centers to perform multiple complex multidisciplinary procedures should be mandatory. Late vascular repair has not shown to be associated with worse results.
Copyright © 2022 Elsevier Inc. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0039-6060, 1532-7361
- Tipo:
- Article
- Páginas:
- 1067-1075
- PubMed:
- 35965144
- Factor de Impacto:
- 1,236 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
Surgery MOSBY-ELSEVIER
Citas Recibidas en Web of Science: 3
Documentos
- No hay documentos
Filiaciones
Keywords
- BILE-DUCT INJURY; HEPATIC-ARTERY INJURY; LAPAROSCOPIC CHOLECYSTECTOMY; VASCULOBILIARY INJURY; LIVER-TRANSPLANTATION; MAJOR HEPATECTOMY; BILIARY INJURY; MANAGEMENT; COMPLICATIONS; IMPACT
Campos de Estudio
Cita
Lopez V,Kuemmerli C,Cutillas J,MAUPOEY J,LOPEZ R,Ramos E,Mils K,Valdivieso A,Valero AP,Martinez PA,Paterna S,Serrablo A,Reese T,Oldhafer K,Brusadin R,Conesa AL,Valladares LD,Loinaz C,Garces M,Sabater L,Mocchegiani F,Vivarelli M,Pérez SA,Flores B,Lucena JL,Sanchez S,Calero A,Minguillon A,Ramia JM,Alcazar C,Aguilo J,Ruiperez JA,Grochola LF,Clavien P,Petrowsky H,Robles R. Vascular injury during cholecystectomy: A multicenter critical analysis behind the drama. Surgery. 2022. 172. (4):p. 1067-1075. IF:3,800. (1).