Bile duct injuries during open and laparoscopic cholecystectomy in the laparoscopic era: alarming trends

Karvonen, Jukka; Grönroos, Juha

doi:10.1007/s00464-011-1641-1

Cited by 38 publications

(36 citation statements)

References 28 publications

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“…There are also results on the opposite trend – BDI injuries having become more common after OC – which raises concern on surgeons in training not learning appropriate technique for OC in the laparoscopic era [27]. Patients chosen for conversion or direct OC are however often suffering from a more severe inflammation that makes the tissues more prone to rupture and hence patients who have their surgery finished as an open procedure might be at risk for BDI due to inflamed, rupture-prone tissues rather than inadequate surgical technique.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

2016

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BackgroundThe purpose of the study was to identify risk factors for conversion of laparoscopic cholecystectomy and risk factors for postoperative complications in acute calculous cholecystitis. The most common complications arising from cholecystectomy were also to be identified.MethodsA total of 499 consecutive patients, who had undergone emergent cholecystectomy with diagnosis of cholecystitis in Meilahti Hospital in 2013–2014, were identified from the hospital database. Of the identified patients, 400 had acute calculous cholecystitis of which 27 patients with surgery initiated as open cholecystectomy were excluded, resulting in 373 patients for the final analysis. The Clavien-Dindo classification of surgical complications was used.ResultsLaparoscopic cholecystectomy was initiated in 373 patients of which 84 (22.5%) were converted to open surgery. Multivariate logistic regression identified C-reactive protein (CRP) over 150 mg/l, age over 65 years, diabetes, gangrene of the gallbladder and an abscess as risk factors for conversion. Complications were experienced by 67 (18.0%) patients. Multivariate logistic regression identified age over 65 years, male gender, impaired renal function and conversion as risk factors for complications.ConclusionsAdvanced cholecystitis with high CRP, gangrene or an abscess increase the risk of conversion. The risk of postoperative complications is higher after conversion. Early identification and treatment of acute calculous cholecystitis might reduce the number of patients with advanced cholecystitis and thus improve outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13017-016-0111-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

2016

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“…In addition, most of the open procedures were performed in the first years of the study period. The reported frequency of bile duct injuries varies considerably in published studies (3,4,15) . Retrospective studies might contain selection bias, thereby giving a too low incidence of injuries.…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Injuries Following Laparoscopic Cholecystectomy and their Outcome

Ahsan¹

2017

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“…It is generally believed that the extra-hepatic bile duct with smaller diameter is more prone to be injured during cholecystectomy [18,19]. For these patients, the success rate of HJ is relatively lower if the proximal bile duct segments of the stenosis are not dilated, circumstances that are present in more than half of patients.…”

Section: Discussionmentioning

confidence: 99%

Progressive balloon dilatation following hepaticojejunostomy improves outcome of bile duct stricture after iatrogenic biliary injury

et al. 2013

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BackgroundIatrogenic biliary stricture (IBS) is a disastrous complication of cholecystectomy. Although the endoscopic treatments are well accepted as initial attempts for IBS, surgical hepaticojejunostomy (HJ) is often necessary for a considerable proportion of patients. However, the anastomotic stricture after HJ also occurs.MethodsIn the present study, a new procedure, progressive balloon dilation following HJ (HJPBD), was designed and utilized in the IBS treatment. We retrospectively compared HJPBD with the traditional HJ in term of the outcomes when used for IBS treatment.ResultsBetween January 1997 and December 2009, 112 patients with IBS attributed to cholecystectomy enrolled in our hospital were treated with surgical reconstruction with either HJ (n=58) or HJPBD (n=54). Of the 58 patients in HJ group, 48 patients (82.8%) had a successful outcome, while 52 out of 54 patients (96.3%) in HJPBD group achieved success. The successful surgical reconstruction rates were significantly different between these two groups, with a further improved outcome in patient undergone progressive balloon dilation following HJ. Additionally, 8 of the 10 failure cases in HJ group were successfully rescued by HJPBD procedure.ConclusionsOur findings suggest that the new procedure of HJPBD could be successfully applied to IBS patients, and significantly improve the outcome of IBS reconstruction.

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Bile duct injuries during open and laparoscopic cholecystectomy in the laparoscopic era: alarming trends

Cited by 38 publications

References 28 publications

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

Bile Duct Injuries Following Laparoscopic Cholecystectomy and their Outcome

Progressive balloon dilatation following hepaticojejunostomy improves outcome of bile duct stricture after iatrogenic biliary injury

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