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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2015; 7(10): 254-260
Published online Oct 27, 2015. doi: 10.4240/wjgs.v7.i10.254
Published online Oct 27, 2015. doi: 10.4240/wjgs.v7.i10.254
Iatrogenic bile duct injury with loss of confluence
Miguel-Angel Mercado, Mario Vilatoba, Alan Contreras, Pilar Leal-Leyte, Eduardo Cervantes-Alvarez, Juan-Carlos Arriola, Bruno-Adonai Gonzalez, Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan México 14080, DF, México
Eduardo Cervantes-Alvarez, PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, México
Author contributions: Mercado MA, Leal-Leyte P and Cervantes-Alvarez E contributed to study conception and design; Mercado MA and Gonzalez BA contributed to the acquisition of data; Mercado MA, Vilatoba M, Contreras A, Leal-Leyte P, Cervantes-Alvarez E and Gonzalez BA contributed to analysis and interpretation; Mercado MA, Leal-Leyte P and Cervantes-Alvarez E contributed to drafting of manuscript; Mercado MA, Vilatoba M, Contreras A, Leal-Leyte P, Cervantes-Alvarez E and Gonzalez BA contributed to critical review; Arriola JC contributed to the figures.
Institutional review board statement: The study was reviewed and approved by the Research Committee and the Research Ethics Committee of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Miguel-Angel Mercado, MD, Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Tlalpan México 14080, DF, México. mercadiazma@yahoo.com
Telephone: +52-55-54870900-7452
Received: June 5, 2015
Peer-review started: June 5, 2015
First decision: June 18, 2015
Revised: August 21, 2015
Accepted: September 1, 2015
Article in press: September 2, 2015
Published online: October 27, 2015
Processing time: 151 Days and 6.3 Hours
Peer-review started: June 5, 2015
First decision: June 18, 2015
Revised: August 21, 2015
Accepted: September 1, 2015
Article in press: September 2, 2015
Published online: October 27, 2015
Processing time: 151 Days and 6.3 Hours
Core Tip
Core tip: Strasberg E-4 (Bismuth IV) bile duct injuries represent a surgical challenge. These injuries which involve two separated right and left ducts are of multifactorial etiology, and may be the result of ischemic or thermal damage, an inflammatory reaction, or anatomical variants that predispose the patient to injury. The treatment options are many, mainly surgical. Best results are obtained with Roux-en-Y hepatojejunostomies, as we describe in this article.