Med J Bakirkoy. 2020; 16(3): 240-247 | DOI: 10.5222/BMJ.2020.22932

Our Surgical Experience in Choledoch Opening Anomalies

Ahmet Gokhan Saritas¹, Abdullah Ülkü¹, Uður Topal¹, Kubilay Dalcý¹, Burak Yavuz¹, Oguz Uskudar², Atilgan Tolga Akcam^1
1Cukurova University Faculty of Medicine Department Of General Surgery,Adana
²Cukurova University Faculty of Medicine Department Of Gastroenterology,Adana

Objective: The treatment of anomalous opening of the common bile duct opening is performed by endoscopic or surgical methods. In addition to endoscopic procedures, indications of surgical treatment, surgical procedures and complications related to these methods are aimed to be presented in the light of the literature. Method: Patients who underwent surgical treatment for anomalous opening of the common bile duct between November 2014 and August 2018 were analyzed retrospectively. Demographic characteristics, presenting symptoms, diagnostic methods, treatment procedures, complications and postoperative follow-up information were analyzed. Results: A total of 8 patients were included in the study. The mean age was 64.3 years. Male, and female patients constituted 75% (n=6) and 25% (n=2) of the study population. The most common presenting symptoms were abdominal pain (50%) and biliary colic (25%). Cholestatic enzymes were found to be high in 75% of the patients. Fifty-one patients had hyperbilirubinemia. Ectopic biliary drainage was most commonly (75%) located at the bulbus and the second most common (25%) localization was the post-bulbar region. The most common surgical procedure was hepaticojejunostomy (62.5%) and choledochoduodenostomy was performed in 25% of the cases. Conclusion: Surgical treatment methods can be used in addition to endoscopic methods in the treatment of anomalous common bile duct opening. Caution should be exercised in patients undergoing surgical treatment for anastomotic leakage, duodenal ulcer bleeding and bleeding from the area of sphincterotomy.

Keywords: Choledochus, Ectopic opening, Surgical treatmant

---

Koledok Açýlým Anomalilerindeki Cerrahi Deneyimlerimiz

Ahmet Gokhan Saritas¹, Abdullah Ülkü¹, Uður Topal¹, Kubilay Dalcý¹, Burak Yavuz¹, Oguz Uskudar², Atilgan Tolga Akcam^1
1Çukurova Üniversitesi Týp Fakültesi Genel Cerrahi Ana Bilim Dalý,Adana
²Çukurova Üniversitesi Týp Fakültesi Gastroentereoloji Bilim Dalý,Adana

Amaç: Koledok açýlým anomalisinin tedavisi endoskopik ya da cerrahi yöntemler ile yapýlmaktadýr. Endoskopik giriþimlerin yanýsýra cerrahi tedavi endikasyonlarý, uygulanan cerrahi yöntemler ve bu yöntemlere ait komplikasyonlarýn literatür eþliðinde sunulmasý amaçlanmýþtýr. Yöntem: Kliniðimizde Kasým 2014 ile Aðustos 2018 tarihleri arasýnda koledok açýlým anomalisi nedeni ile cerrahi tedavi uygulanan olgular retrospektif olarak analiz edilmiþtir. Hastalarýn demografik özellikleri, baþvuru semptomlarý, taný yöntemleri, tedavi prosedürleri, komplikasyonlar ve postoperatif dönemdeki takip bilgileri analiz edildi. Bulgular: Çalýþmamýza toplam 8 hasta dahil edildi. Ortalama yaþ 64,3 idi. Erkek cinsiyet %75 (n=6), kadýn cinsiyet %25 (n=2) idi. En sýk baþvuru semptomu karýn aðrýsý (%50) ve bilyer kolik (%25) idi. Kolestaz enzimleri hastalarýn %75’inde yüksek bulundu. Yüzde elli olguda ise hiperbilluribinemi mevcuttu. Ektopik bilyer drenaj en sýk (%75) bulbus, ikinci sýklýkta ise (%25) postbulber bölgede idi. En sýk uygulanan cerrahi iþlem (%62,5) hepatikojejunostomi, %25 olguda ise koledokoduodenostomi idi. Sonuç: Koledok açýlým anomalisi tedavisinde endoskopik yöntemlerin yanýsýra cerrahi tedavi yöntemleri de uygulanabilmektedir. Cerrahi tedavi uygulanan hastalarda anastomoz kaçaðý, duodenal ülser kanamasý ve sfinkterotomi alanýndan kanama açýsýndan dikkatli olunmalýdýr.

Anahtar Kelimeler: Koledok, Ektopik Açýlým, Cerrahi tedavi

---