Laparosc Endosc Surg Sci . 2018; 25(3): 121-124 | DOI: 10.14744/less.2018.71224

Autologous mesenteric vein and peritoneum for repair of portal vein and hepatic artery injuries accompanying bile duct injury following laparoscopic cholecystectomy

Volkan Ince¹, Sertaç Usta¹, Tamer Ertan², Halil Armaðan², Cüneyt Kayaalp^1
1Department of General Sergery, Ýnönö University, Liver Transplantation Institute, Malatya, Turkey
²Department of General Surgery, Kayseri Training and Research Hospital, Kayseri, Turkey

Biliary tract injuries are still the most hazardous complications of laparoscopic cholecystectomy. Concomitant vascular injuries make them further more complicated and complex surgical interventions including autologous grafting can be required. We presented a 32-year-old female referred us with combined bile duct, portal vein and hepatic artery injuries occurred during laparascopic surgery. The repairs of hepatic artery and portal vein were achieved by autologous inferior mesenteric vein and peritoneum grafts, respectively. Bile duct reconstruction was done by Roux-en-Y hepaticojejunostomy. Postoperative course was uneventful and she was asymptomatic following 16 months follow-up. Autologous vein and peritoneal grafts can be used for repair of vascular injuries of laparascopic cholecystectomy.

Keywords: Additional vascular lesion, biliary tract injury; patch plasty; peritoneum.

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Laparoskopik kolesistektomi sonrasý safra kanalý yaralanmasýna eþlik eden portal ven ve hepatik arter yaralanmalarýnýn otolog mezenterik ven ve periton ile onarýmý

Volkan Ince¹, Sertaç Usta¹, Tamer Ertan², Halil Armaðan², Cüneyt Kayaalp^1
1Inönü Üniversitesi, Karaciðer Nakli Enstitüsü, Genel Cerrahi Ana Bilim Dalý
²Kayseri Eðitim Ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði

Sayra yolu yaralanmalarý halen en sýk laparaskopik kolesistektomi ameliyatý sýrasýnda oluþmaktadýr. Eþlik eden damar yaralanmasý, durumu daha komplike hale getirir ve yaralanmalarýnýn cerrahi onarýmýnda, otolog ya da allojenik greftler kullanýlmasý gibi karmaþýk iþlemler gerektirir. Laparaskopik kolesistektomi ameliyatý sýrasýnda oluþan, sað hepatik arter kesisinin otolog inferior mezenterik ven interpozisyon grefti ile, sað portal ven yaralanmasýnýn otolog pariyetal periton yama grefti ile ve koledok kesisinin Roux-en-Y hepatikojejunostomi le onarýldýðý otuz-iki yaþýnda kadýn hasta sunulmaktadýr.

Anahtar Kelimeler: safra yolu yaralanmasý, periton, patch plasty, damar yaralanmasý

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