Clinical Application of the Hanover Classification for Iatrogenic Bile Duct Lesions

Table 2

Therapeutic methods and results of 93 patients with bile duct reconstruction after iatrogenic bile duct injuries.

Primary therapy in the local hospital	𝑛=93
Exclusive endoscopic therapy with stent	8
Explorative laparotomy +	29
and transfer without reconstruction	10
and suture	5
and T-drain	9
and drain	5
Drainage only	3
Hemihepatectomy + biliodigestive anastomosis	1
E/E reconstruction	6
Biliodigestive anastomosis	18
No further primary therapy	28
Therapy after referral to our centre	𝑛=93
Explorative laparotomy and removal of a clip	2
Explorative laparotomy and suturing	5
Explorative laparotomy and adhesiolysis	3
Drainage only	1
Hepaticojejunostomy	53
Hepaticojejunostomy and reconstruction of a. hep. com	1
Right hemihepatectomy only	2
Liver segment resection	2
Hemihepatectomy with hepaticojejunostomy	13
Re-hepaticojejunostomy	9
Whipple’s procedure	2
Subsequent interventions at our centre	𝑛=17
Re-hepaticojejunostomy	4
Partial resection of the liver	1
Liver transplantation	2
Incisional hernia	7
Closure of a tracheostoma	2
Relaparotomy due to adhesion ileus	1
Complications requiring revision	𝑛=19
Secondary haemorrhage	3
Bileleak	7
Anastomotic insufficiency of a hepaticojejunostomy	2
Peritonitis	4
Duodenal perforation	2
Obstruction of the hepatic artery and the portal vein	1
Hospital lethality	𝑛=3
Primarily injured common hepatic artery followed by sepsis in all cases
Follow-up period	𝑛=63
Symptom-free	38
Symptoms due to adhesions	7
Pain in the region of the scar	3
Recurrent cholangitis	15