2008
DOI: 10.1177/1553350608318144
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Abstract: Common bile duct injury is a serious but uncommon complication of laparoscopic cholecystectomy. A case-control epidemiologic study of patients who had undergone cholecystectomy in Ontario, Canada, between 1991 and 1997 was performed. Four patients who had undergone a laparoscopic cholecystectomy at the same hospital 2 months prior to a case were selected as controls. The risk of bile duct injury associated with various exposures was estimated by unconditional logistic regression. There were 28 cases and 88 con… Show more

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Cited by 25 publications
(20 citation statements)
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References 33 publications
(44 reference statements)
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“…Since major bile duct injuries with laparoscopic cholecystectomy are most frequently due to duct misidentification [16,17], techniques for prevention and/or recognition focus primarily on careful anatomic definition [18] to ensure the ''critical view'' prior to dividing any structures [19,20] including dissection (1) to completely expose and delineate the hepatocystic triangle, (2) to identify a single duct and a single artery entering the gallbladder, and (3) to completely dissect the lower part of the gallbladder off the liver bed. Though the protective effect of the practice continues to be debated, routine use of intraoperative cholangiography may decrease the risk or severity of injury and improve injury recognition [17,[21][22][23]. The general principle of not dividing any structure until you are certain of its identification applies here; the need for caution and vigilance cannot be overstated given evidence which supports visual misperception as an underlying cause of major bile duct injury [24], coupled with the potential for complacency which may result from the rarity of bile duct injuries.…”
Section: Safe Techniquementioning
confidence: 99%
“…Since major bile duct injuries with laparoscopic cholecystectomy are most frequently due to duct misidentification [16,17], techniques for prevention and/or recognition focus primarily on careful anatomic definition [18] to ensure the ''critical view'' prior to dividing any structures [19,20] including dissection (1) to completely expose and delineate the hepatocystic triangle, (2) to identify a single duct and a single artery entering the gallbladder, and (3) to completely dissect the lower part of the gallbladder off the liver bed. Though the protective effect of the practice continues to be debated, routine use of intraoperative cholangiography may decrease the risk or severity of injury and improve injury recognition [17,[21][22][23]. The general principle of not dividing any structure until you are certain of its identification applies here; the need for caution and vigilance cannot be overstated given evidence which supports visual misperception as an underlying cause of major bile duct injury [24], coupled with the potential for complacency which may result from the rarity of bile duct injuries.…”
Section: Safe Techniquementioning
confidence: 99%
“…Die perforierte Cholezystitis als abdominelle Sepsisquelle birgt bei laparoskopischem Vorgehen ein erhöhtes Risiko iatrogener Gallengangsverletzungen [26]. Verlorene intraabdominelle Gallensteine verursachen bei freier Perforation oder akzidenteller perioperativer Verteilung im Bauchraum gemäß einer retrospektiven Studie [27] mehr postoperative Schmerzen, Ileus, mehr Infektionen an den Trokarstellen und konsekutiv einen verlängerten Krankenhausaufenthalt.…”
Section: Spezielles Vorgehen Bei Bestimmten Krankheitsbildernunclassified
“…E XTRAHEPATIC biliary tract lesions occurring during laparoscopic cholecystectomy are burdened by perioperative morbidity and mortality [1,2], reduction of longterm survival [3], and reduction of the patient's quality of life [4,5]. Although the incidence of biliary injury during laparotomy is 0.1%e0.2% [6], in the case of the laparoscopic approach it becomes w2-fold or even 3-fold higher [7].…”
Section: Introductionmentioning
confidence: 99%
“…E XTRAHEPATIC biliary tract lesions occurring during laparoscopic cholecystectomy are burdened by perioperative morbidity and mortality [1,2], reduction of longterm survival [3], and reduction of the patient's quality of life [4,5]. Although the incidence of biliary injury during laparotomy is 0.1%e0.2% [6], in the case of the laparoscopic approach it becomes w2-fold or even 3-fold higher [7].Various attempts have been made to reconstruct the bile duct with the use of nonabsorbable vascular grafts, such as expanded polytetrafluoroethylene, with unsatisfactory results due to a high rate of stenosis, early-occurring infections, and long-term foreign body reactions [8e12]. Autologous grafts have been proposed as possible prosthetic material, but they showed extremely low results in the long term [13e16].…”
mentioning
confidence: 99%
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