TY  - JOUR
T1  - Invited critique: Operative repair of bile duct injuries involving the hepatic duct confluence
AU  - Hines O, Reber HA
Y1  - 1999/07/01
N1  - 10.1001/archsurg.134.7.775
JO  - Archives of Surgery
SP  - 775
EP  - 775
VL  - 134
IS  - 7
N2  - 
As the authors suggest, the early management of these patients should focus on accurate delineation of the injury, control of infection (cholangitis and/or abscess), and drainage of the bile. Biliary drainage may be external via a surgically placed drain, or through a transhepatic tube inserted by the radiologist when a transhepatic cholangiogram is done. If the obstruction is incomplete, it may even be possible to pass the stent through the injured area into the duodenum, which is desirable. In patients who have experienced significant inflammation or infection at the time of the initial injury, we recommend a 3- to 6-month wait before definitive repair, provided that intubation relieves the obstruction and controls cholangitis.

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.134.7.775
UR  - http://dx.doi.org/10.1001/archsurg.134.7.775
ER  -