Bile Duct Injury During Laparoscopic Cholecystectomy

Nuzzo, Gennaro; Giuliante, Felice; Giovannini, Ivo; Ardito, Francesco; D’Acapito, Fabrizio; Vellone, Maria; Murazio, Marino; Capelli, Giovanni

doi:10.1001/archsurg.140.10.986

Cited by 355 publications

(112 citation statements)

References 37 publications

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“…Laparoscopic cholecystectomy is widely accepted as an effective treatment for benign gallbladder disease, but bile duct injury remains a serious complication, with an incidence of 0.3%–0.7% 1, 2, 3, 4, 5, 6. Bile duct injury is often caused by misinterpretation of the anatomical structures rather than by insufficient technical skills 7.…”

Section: Introductionmentioning

confidence: 99%

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

Tsutsui

Yoshida

Nakagawa

et al. 2017

Asian J Endoscop Surgery

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IntroductionThe PINPOINT® Endoscopic Fluorescence Imaging System (Novadaq, Mississauga, Canada) allows surgeons to visualize the bile ducts during laparoscopic cholecystectomy. Surgeons can continue operation while confirming the bile ducts’ fluorescence with a bright‐field/color image. However, strong fluorescence of the liver can interfere with the surgery. Here, we investigated the optimal timing of indocyanine green administration to allow fluorescent cholangiography to be performed without interference from the liver fluorescence.MethodsA total of 72 patients who underwent laparoscopic cholecystectomy were included in this study. The timing of indocyanine green administration was set immediately before surgery and at 3, 6, 9, 12, 15, 18, and 24 h before surgery. The luminance intensity ratios of gallbladder/liver, cystic duct/liver, and common bile duct/liver were measured using the ImageJ software (National Institutes of Health, Bethesda, USA). Visibility of the gallbladder and bile ducts was classified into three categories (grades A, B, and C) based on the degree of visibility in contrast to the liver.ResultsThe luminance intensity ratio for the gallbladder/liver, cystic duct/liver, and common bile duct/liver was ≥1 in the 15‐, 18‐, and 24‐h groups. The proportion of cases in which evaluators classified the visibility of the gallbladder and bile ducts as grade A (best visibility) reached a peak in the 15‐h group and decreased thereafter.ConclusionsIn the present study, the optimal timing of indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT Endoscopic Fluorescence Imaging System was 15 h before surgery.

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Section: Introductionmentioning

confidence: 99%

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

Tsutsui

Yoshida

Nakagawa

et al. 2017

Asian J Endoscop Surgery

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“…[1] The major disadvantage of the laparoscopic technique is the increased incidence of bile duct injuries, which may result in considerable morbidity. [1][2][3][4] Healthrelated quality of life after bile duct injury in comparison with uncomplicated laparoscopic cholecystectomy has been shown to be adversely affected as measured by psychological outcome, while physical outcomes appear to be similar. [13] Little information is available to accurately quantify the overall financial implications of a bile duct reconstruction, incorporating such diverse costs as loss of income due to time off work, travel expenses, medical fees, rehabilitation and possible litigation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] While minor injuries with duct continuity can be treated successfully with endoscopic stenting without recourse to operation, major injuries with duct division are life-threatening and may require complex biliary reconstructive surgery. [5] Optimal evaluation of a major bile duct injury requires careful, co-ordinated, multidisciplinary assessment by a knowledgeable group of surgeons, intensivists, endoscopists and interventional radiologists.…”

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confidence: 99%

A cost analysis of operative repair of major laparoscopic bile duct injuries

2015

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Background. Major bile duct injuries occur infrequently after laparoscopic cholecystectomy, but may result in life-threatening complications. Few data exist on the financial implications of duct repair. This study calculated the costs of operative repair in a cohort of patients who underwent reconstruction of the bile duct after major ductal injury. Objective. To calculate the total in-hospital cost of surgical repair of patients referred with major bile duct injuries. Methods. A prospective database was reviewed to identify all patients referred to the University of Cape Town Private Academic Hospital, South Africa, between 2002 and 2013 for assessment and repair of major laparoscopic bile duct injuries. The detailed clinical records and billing information were evaluated to determine all costs from admission to discharge. Total costs for each patient were adjusted for inflation between the year of repair and 2013. Results. Forty-four patients (33 women, 11 men; median age 48 years, range 30 -78) underwent reconstruction of a major bile duct injury. First-time repairs were performed at a median of 24.5 days (range 1 -3 662) after initial surgery. Median hospital stay was 15 days (range 6 -86). Mean cost of repair was ZAR215 711 (range ZAR68 764 -980 830). Major contributors to cost were theatre expenses (22%), admission to intensive care (21%), radiology (17%) and specialist fees (12%). Admission to a general ward (10%), consumables (7%), pharmacy (5%), endoscopy (3%) and laboratory costs (3%) made up the balance. Conclusions. The cost of repair of a major laparoscopic bile duct injury is substantial owing to prolonged hospitalisation, complex surgical intervention and intensive imaging requirements.

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“…According to the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) the current rate of major bile duct injury in laparoscopic cholecystectomy has stabilised at 0.1-0.6% [120][121][122][123][124][125][126] and series with no major bile duct injuries have been reported. 127 Although many believe that the rate of major bile duct injury in open cholecystectomy is lower than laparoscopic cholecystectomy, controversy remains.…”

Section: Complications During and After Laparoscopic Surgerymentioning

confidence: 99%

Clinical effectiveness and cost-effectiveness of cholecystectomy compared with observation/conservative management for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones or cholecystitis: a systematic review and economic evaluation

Brazzelli

Cruickshank

Kilonzo

et al. 2014

Health Technology Assessment

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 12/16/01. The contractual start date was in August 2012. The draft report began editorial review in May 2013 and was accepted for publication in October 2013. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Background: Approxi...

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Bile Duct Injury During Laparoscopic Cholecystectomy

Cited by 355 publications

References 37 publications

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

A cost analysis of operative repair of major laparoscopic bile duct injuries

Clinical effectiveness and cost-effectiveness of cholecystectomy compared with observation/conservative management for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones or cholecystitis: a systematic review and economic evaluation

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