EVALUATION OF THE SURGICAL MANAGEMENT AND REMOTE OUTCOMES IN PATIENTS WITH POSTOPERATIVE BILIARY STRICTURES IN THE REPUBLIC OF MOLDOVA

• Main Author: Alexandru Ferdohleb
• Format: Article
• Language: English
• Published: “Francisc I. Rainer” Anthropology Institute of the Romanian Academy. 2017-07-01
• Series: Anthropological Researches and Studies
• Subjects: biliary strictures; etiopathogenic diagnosis; hepaticojejunostomy; reconstructive surgery act; biliary duct
• Online Access: http://www.journalstudiesanthropology.ro/en/evaluation-of-the-surgical-management-and-remote-outcomes-in-patients-with-postoperative-biliary-strictures-in-the-republic-of-moldova/a72/

Objectives. Surgical management of patients with benign biliary strictures and biliary lesions is a current issue for discussion and raises many scientific research directions. The purpose of this study was to systematize our experience in the treatment of benign biliary strictures, analyzing both immediate and remote complex results. Material and methods. Between 1989-2015 years, there were 203 hospitalized patients with benign biliary strictures in Surgery Department no. 2 of Public Institution, State Medical, and Pharmaceutical University (PI SMPhU) “Nicolae Testemitanu”. The study is conducted as part of postdoctoral research; thesis/dissertation title is Clinical-functional efficiency of modern surgical treatment of benign biliary strictures according to immediate and remote clinical results and was approved by the Science Council of PI SMPhU “Nicolae Testemiţanu” and Ethical Committee (EC) of Ministry of Health (MoH). Clinical evaluation included several consecutive steps: 1) setting the etiopathogenic diagnosis; 2) pre-operatory decompression of the biliary tree; 3) reconstructive surgical act. In the case of biliary strictures, after the initial assessment, biliodigestive derivations were performed according to the level of the obstacle, preferring the bilio-jejunal anastomosis with a Roux-en-Y excluded loop. The post-operatory mortality was 2.63%. Conclusions. The iatrogenic stricture of bile duct has a complicated evolution, with many surgeries, requiring many hospitalizations. It should be endeavored to detect them in a timely manner and to prevent septic complications. In the first phase, biliary tree decompression will be used, and after decreasing the inflammatory process biliary-digestive reconstruction will be performed. These patients require a complex remote monitoring and analysis of health status.