Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Martin, David K.; Uldry, Émilie; Demartines, Nicolas; Halkic, Nermin

doi:10.5582/bst.2016.01065

Cited by 33 publications

(25 citation statements)

References 17 publications

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“…Full texts were thus evaluated, including the relative references of each study. Finally, a total of 31 reports were included in the analysis . The PRISMA diagram is given in Figure .…”

Section: Resultsmentioning

confidence: 99%

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Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

Guerra

Coletta

Gavioli

et al. 2020

J Hepato Biliary Pancreat

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Background In recent years there has been a growing interest in the application of minimally invasive surgery in the management of cholecystectomy‐related injury to the biliary tract. The aim of this analysis was to identify and combine the available evidence on the argument, with particular reference to major injuries to the main bile duct requiring biliodigestive anastomosis. Methods The PubMed/MEDLINE, Embase, and Web of Science electronic databases were queried through May 2019. Inclusion criteria considered all studies reporting detailed data about patients with bile duct injury following cholecystectomy receiving minimally invasive (both laparoscopic and robotic) surgical repair. Clinical outcomes data were pooled and analyzed. Results A total of 31 studies reporting on the outcomes of 218 patients were eventually included in the analysis, whereby 148 patients with type D or E injury. Of these, there were 31 patients (21%) receiving direct bile duct repair and 117 patients (79%) undergoing bilioenteric reconstruction. Among patients with major bile duct injury, postoperative morbidity was 24%, being 12% the incidence of major complications and 6% the rate of patients requiring subsequent, further surgery. Conclusions The absence of high‐level evidences precludes the possibility to draw definitive conclusions. However, the available data derived from a growing number of centers demonstrate that minimally invasive surgery may offer its well‐known advantages on postoperative outcomes also in the setting of severe iatrogenic injury to the bile ducts.

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“…Full texts were thus evaluated, including the relative references of each study. Finally, a total of 31 reports were included in the analysis . The PRISMA diagram is given in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…Of 31 patients (21%) received direct repair of the biliary tract. Of these, nine patients received direct suture, while the remaining 18 patients underwent bile duct suture (either partial suture or end‐to‐end anastomosis) over T‐tube . 7% of procedures were converted into an open surgery (two out of 27 patients with operative details).…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

Guerra

Coletta

Gavioli

et al. 2020

J Hepato Biliary Pancreat

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“…Over the past decades, the literatures reported incidence of major BDI after laparoscopic cholecystectomy (LC) is about 0.3-0.5% (1)(2)(3). Recently, a prospective cohort study showed that complexity of referred BDI and rate of associated vascular injuries have increased over time (4).…”

Section: Introductionmentioning

confidence: 99%

Management for a complicated biliary stricture after iatrogenic bile duct injury

et al. 2017

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Bile duct injury (BDI) remains to be a serious complication of biliary surgery. Biliary stricture is likely to occur in cases without proper management of BDI, may be causing such severe complications as repeated strictures, cholangitis or impairment to liver function. Here, we reported a 69-year-old man with a one-more-year history of recurrent cholangitis caused by iatrogenic BDI. The patient underwent a reconstruction of choledochojejunostomy, with liver quadrate lobectomy, and hilar cholangioplasty. The procedure was difficult, but the recovery was smooth. Only through comprehensive pre-operative evaluation and meticulous intraoperative manipulate, the technical challenge of re-operation for complicated biliary stricture after BDI should be easily addressed. cholangiopancreatography (MRCP) and computed tomographic angiography of the liver and biliary tract. MRCP showed stricture at hilar bile duct and dilatation of intrahepatic bile duct (Figure 1). Following a thorough discussion of treatment options and associated benefits and risks with the patient, we decided to proceed with a reconstruction of choledochojejunostomy. Risks and complications of the procedure included biliary leak, cholangitis, bleeding, anastomotic strictures, biliary cirrhosis, and the need for further surgeries. Pre-operative preparationPrior to the procedure, complete blood count, liver function test, coagulation function test, and cardiopulmonary function assessment were ordered (all normal) in addition to a full physical examination and patient history. Antibiotics were administered in that sequence no more than 30 minutes prior to the incision. Appropriate consent was obtained from the patient per our institutional protocol.Equipment preference card   Water knife;  Bile duct probes;  Fine catheter;  4-0 Vicryl suture;  5-0 Prolene suture;  Self-retaining wound retractor. ProcedureThe operative procedure is demonstrated in Figure 2. The patient was placed in the supine position. After general anesthesia was induced, a Foley catheter was placed. Through the original incision, a down L-shaped incision below the right rib edge was made. Dense adherence was found in the area of biliary-enteric anastomosis, which was 40 cm away from enteric-enteric anastomosis. Part of the right and quadrate lobe of liver (about 4 cm × 4 cm) was marked and removed. Then, bile duct above the anastomosis was separated by water knife. After finding the original anastomosis, the bile duct was confirmed by a puncture. Part of the anterior wall of the bowel was incised. Anastomotic scar hyperplasia was significantly associated with stenosis. It was found that left and right hepatic was interrupted, and anastomosis of left hepatic duct almost closed.Bile duct wall was separated from the liver tissue until opening the diameter of right hepatic duct to 2 cm, and the left to 2.5 cm. Due to the confluence of left and right hepatic duct to be adhered scar tissue, it was reshaped into an "8" shape with satisfaction. After exploration of the bile duct ...

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“…Only 1/3-1/2 of BDI can be diagnosed in time, more than 70% of BDI is initially repaired by surgeons who do not specialize in such repair surgery (25,26). Nondefinitive surgical exploration and the implementation of definitive repair surgery with inappropriate timing are ubiquitous (12,27). Moreover, delayed referral to a specialist center increases morbidity (28).…”

Section: Introductionmentioning

confidence: 99%

“…BDI mostly occurs in cholecystectomy (5)(6)(7)(8). The incidence of BDI associated with open cholecystectomy (OC) is 0.125-0.3% (9)(10)(11)(12), but the rate is up to 0.4-0.6% for cases that underwent laparoscopic cholecystectomy (LC) (13)(14)(15)(16), as well as increasing complexity (17). With advances in technology, singleincision laparoscopic cholecystectomy and robotic cholecystectomy have been performed, but the incidence of BDI was also reported (18,19), and more rigorous training in biliary surgery may be needed (20,21).…”

Section: Introductionmentioning

confidence: 99%

Surgical management for bile duct injury

Feng

Dong

2017

BST

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Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Cited by 33 publications

References 17 publications

Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

Management for a complicated biliary stricture after iatrogenic bile duct injury

Surgical management for bile duct injury

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