Bile duct injuries: a contemporary survey of surgeon attitudes and experiences

Fletcher, Reid; Cortina, Chandler S.; Kornfield, Hannah; Varelas, Antonios; Li, Ruojia; Veenstra, Benjamin R.; Bonomo, Steven

doi:10.1007/s00464-019-07056-7

Cited by 22 publications

(18 citation statements)

References 18 publications

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“…Conversely, no difference in 1year survival rates was observed in patients with BDIs detected perioperatively compared to those without a BDI [78]. These data demonstrate that the timing of BDI recognition matters; nevertheless, BDIs diagnosed intraoperatively represent only a limited number of cases, although the ranges reported in the literature are highly variable (25-92%) [9,79,102,110,111].…”

Section: Literature Reviewmentioning

confidence: 64%

“…Four studies compared the use of ICG-C to IOC in 215 patients and found no significant differences for cystic duct, common bile duct, or common hepatic duct visualization. A recent survey involving 3411 surgeons (with an average of 16.1 years of practice) highlighted how the use of adjuncts such IOC, ICG-C, or intraoperative ultrasound, either routinely or selectively during difficult cholecystectomies, is not significantly associated with a lower risk of BDIs [9]. It is important to emphasize that factors such as geographic distance between facilities, equipment, expertise, and logistics, vary significantly between institutions.…”

Section: Management Of Intraoperatively Diagnosed Bdimentioning

confidence: 99%

“…Laparoscopic cholecystectomy (LC) is the gold standard operation for patients with gallstone disease and represents one of the most common routine interventions performed worldwide in both elective and emergency settings [4,5]. Bile duct injuries (BDIs) are dangerous complications of cholecystectomy, occurring more often since the introduction and widespread adoption of laparoscopy (0.4-1.5% of cases) compared to open cholecystectomy (0.2-0.3% of cases) [4,[6][7][8][9]. Since early reports, the frequency of BDIs during LC has been progressively decreasing.…”

Section: Introductionmentioning

confidence: 99%

“…However, some BDIs may be discovered later in the postoperative period, and this often translates to delayed or inappropriate treatments, especially when BDI patients need to be referred from a secondary hospital to a tertiary care center for definitive management. Providing a specific diagnosis and a precise description of the BDI facilitates the decisionmaking process and increases the chance of treatment success [9,18]. In delayed cases, the choice and timing of the appropriate reconstructive procedure have a critical role in long-term prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there is a wide spectrum of interventions used in the management of BDI with different degrees of invasiveness, ranging from computed tomography (CT)-guided drainage to various endoscopic and surgical techniques. With such a variety of interdisciplinary options available and the need to act promptly, close cooperation between gastroenterologists, radiologists, and surgeons is of upmost importance [4,9,[17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

et al. 2021

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Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

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Section: Literature Reviewmentioning

confidence: 64%

Section: Management Of Intraoperatively Diagnosed Bdimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

et al. 2021

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Post-operative complications of cholecystectomy: what the radiologist needs to know

Kazi,

Siddiqui,

Thimmappa

et al. 2024

Abdom Radiol

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Cholecystectomy is one of the most performed surgical procedures. The safety of this surgery notwithstanding, the sheer volume of operations results in a notable incidence of post-cholecystectomy complications. Early and accurate diagnosis of such complications is essential for timely and effective management. Imaging techniques are critical for this purpose, aiding in distinguishing between expected postsurgical changes and true complications. This review highlights current knowledge on the indications for cholecystectomy, pertinent surgical anatomy and surgical technique, and the recognition of anatomical variants that may complicate surgery. The article also outlines the roles of various imaging modalities in identifying complications, the spectrum of possible postsurgical anatomical changes, and the implications of such findings. Furthermore, we explore the array of complications that can arise post-cholecystectomy, such as biliary system injuries, gallstone-related issues, vascular complications, and the formation of postsurgical collections. Radiologists should be adept at identifying normal and abnormal postoperative findings to guide patient management effectively. Graphical abstract

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Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

et al. 2022

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Background This cross‐sectional survey aimed to determine whether fluorescence cholangiography using indocyanine green (ICG‐FC) can improve the detection of the cystic duct and the main bile duct during laparoscopic cholecystectomy (LC). Methods The survey was distributed to 214 surgeons (residents/faculties) in 2021. The confidence in the identification of the cystic duct and of the main bile duct was elicited on a 10‐point Likert scale before/after the use of ICG‐FC. This was repeated for three LCs ranging from a procedure deemed easy to a LC for acute cholecystitis. Results There were 149 responses. ICG‐FC increased the responders’ confidence in identifying the cystic duct, raising the median value from 6 (IQR, 5–8) with white light up to 9 (IQR, 9–10) with ICG‐FC (paired p < 0.001). This increase was even more evident when identifying the main bile duct, where the median confidence value increased from 5 (IQR, 4–7) with white light to 9 (IQR, 8–10) with the use of ICG‐FC (p < 0.001). ICG‐FC significantly increased the detection of residents of the main bile duct in case of intermediate difficulty LCs and in LCs for acute cholecystitis. Conclusions The results support that the use of near‐infrared imaging can ameliorate detection of biliary structures, especially of the main bile duct and this was particularly true for young surgeons and in more complex situations.

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Bile duct injuries: a contemporary survey of surgeon attitudes and experiences

Cited by 22 publications

References 18 publications

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Post-operative complications of cholecystectomy: what the radiologist needs to know

Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

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