{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:10:35Z","timestamp":1785845435219,"version":"3.56.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T00:00:00Z","timestamp":1374883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Improved surgical techniques, substantial preoperative diagnostics, and advanced perioperative management permit extensive and complex liver resection. Thus, hepatic malignancies that would have been considered inoperable some years ago may be curatively resected today. Despite all this progress, biliary leakage remains a clinically relevant issue, especially after extended liver resection. Intraoperative decompression of bile ducts by means of distinct biliary drains is controversial. Although drainage is rarely used as a routine procedure, it might be useful in selected patients at high risk for biliary leakage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe surgical management of long\u2010segment exposed or injured bile ducts after extended parenchymal resection with concomitant lymphadenectomy. Because blood supply to the bile duct may be impaired, the risk of biliary necrosis and\/or leakage is significant. Internal splinting of the bile duct to ensure optimum decompression plus guidance might be helpful. Thus, in selected cases after trisectionectomy we inserted an external\u2013internal or internal\u2013external drain into long\u2010segment exposed bile ducts. For internal\u2013external drains the tube was diverted via the major duodenal papilla into the duodenum and then transfixed after the duodenojejunal flexure through the jejunal wall by means of a Witzel\u2019s channel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Because the entire bile duct is splinted, this technique is superior to bile duct decompression with a T\u2010tube. This is supported by the course of a patient suffering biliary leakage after extended right\u2010sided hepatectomy for colorectal metastasis. Initially, a T\u2010tube was inserted for decompression, but biliary leakage persisted. After inserting transhepatic external\u2013internal drainage, bile leakage stopped immediately. The patient\u2019s course was then uneventful. Five other patients (mostly with locally advanced hepatocellular or cholangiocellular carcinoma) treated similarly were discharged without complications. Drain removal 6 weeks postoperatively was uncomplicated in five of the 6 patients. In the sixth patient, external\u2013internal drainage was replaced by a Yamakawa\u2010type prosthesis for a biliary stricture. None of the patients suffered severe complications during long\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The bile duct drainage technique presented in this study was useful for preventing and treating bile leakage after long\u2010segment exposure of extrahepatic bile ducts during major hepatectomy. Transhepatic or internal\u2013external drains are often used for bilioenteric anastomoses, but similar drainage techniques have not been reported for the native bile duct. T\u2010tubes are generally used in this situation. In particular cases, however, inner splinting of the bile duct and appropriate movement of the bile via a tube can be helpful.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2161-z","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T02:22:26Z","timestamp":1374891746000},"page":"2629-2634","source":"Crossref","is-referenced-by-count":11,"title":["Intraoperative Placement of External Biliary Drains for Prevention and Treatment of Bile Leaks After Extended Liver Resection Without Bilioenteric Anastomosis"],"prefix":"10.1002","volume":"37","author":[{"given":"B.","family":"Str\u00fccker","sequence":"first","affiliation":[{"name":"General, Visceral, and Transplantation Surgery Charit\u00e9 \u2010 Campus Virchow Augustenburger Platz 1 13353 Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Stockmann","sequence":"additional","affiliation":[{"name":"General, Visceral, and Transplantation Surgery Charit\u00e9 \u2010 Campus Virchow Augustenburger Platz 1 13353 Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Denecke","sequence":"additional","affiliation":[{"name":"Department of Radiology Charit\u00e9 Campus Virchow Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Neuhaus","sequence":"additional","affiliation":[{"name":"General, Visceral, and Transplantation Surgery Charit\u00e9 \u2010 Campus Virchow Augustenburger Platz 1 13353 Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Seehofer","sequence":"additional","affiliation":[{"name":"General, Visceral, and Transplantation Surgery Charit\u00e9 \u2010 Campus Virchow Augustenburger Platz 1 13353 Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,27]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v2.i2.94"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)61347\u20100"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100031\u20101271579"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000217605.66519.38"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000129491.43855.6b"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.12.002"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100030\u20101247331"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010012\u20102000\u20109"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20101960\u20106"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181bd920a"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200103000\u201000019"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(98)70015\u20107"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001470050115"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181a5cf3f"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.4.402"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20101999\u2010145"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010001\u20100162\u20109"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-013-2161-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-013-2161-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-013-2161-z","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T23:30:38Z","timestamp":1703633438000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-013-2161-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,27]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1007\/s00268-013-2161-z"],"URL":"https:\/\/doi.org\/10.1007\/s00268-013-2161-z","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,27]]}}}