Artigos Nacionais - Resumo

The extrahepatic biliary ducts injury: Report on 14 cases.
Autores: Zantut, L.F.C.; Machado, M.A.C. ; Volpe, P.; Poggetti, R.S.; Birolini, D.
Rev. Paul. Med. 114(6):1309-1311, 1996.



During the 6-year period from 1986 through 1991, 5069 patients underwent laparotomy for abdominal trauma at the Department of Surgery University of São Paulo School of Medicine. Fourteen patients (0.28 %) had injuries involving the extrahepatic biliary ducts. Records, including operative and pathology reports, were reviewed to study the site of injury, associated intra-abdominal injuries, incidence, trauma scores, type of repair, morbidity and mortality rates. There were 13 male and 1 female patients with a mean age of 23.2 years (range, 15-30 years). Of the 14 extrahepatic biliary ducts injuries, 11 (78.6%) were caused by penetrating wounds and three by blunt trauma. In the 14 patients, 48 intra-abdominal injuries were found or 3.4 per patient. Ten of the 14 patients (71.4%) had lacerations of the liver. Pancreas lacerations (7 patients), gastric lacerations (5 patients) and duodenal lacerations (5 patients) were the next most commonly seen injuries. Three patients died (21.4%), none as a result of their biliary duct injury. The most frequent site of lesion was distal common bile duct (50%). We concluded that the type of repair employed in our series was related to the hemodynamic stability and clinical conditions (based on trauma scores) of the patient more than the site and complexity of the injury.