Does increased experience with laparoscopic cholecystectomy yield more complex bile duct injuries?

Chuang, Kelley; Corley, Douglas; Postlethwaite, Debbie; Merchant, Maqdooda; Harris, Hobart W.

doi:10.1016/j.amjsurg.2011.08.018

Cited by 41 publications

(27 citation statements)

References 27 publications

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“…This is in the same order as was found in an extensive American study comprising83,000 patients whereabout60% of the leaks were related to the cystic duct (5) . As many as 12% of the operations in our series were open cholecystectomies and another 15% were conversions from laparoscopic to open surgery.…”

Section: Discussionsupporting

confidence: 69%

Bile Duct Injuries Following Laparoscopic Cholecystectomy and their Outcome

Ahsan¹

2017

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Section: Discussionsupporting

confidence: 69%

Bile Duct Injuries Following Laparoscopic Cholecystectomy and their Outcome

Ahsan¹

2017

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“…The Bismuth classification is based on the level of injury in the CBD, from distal to proximal 16. With LC, BDI is becoming more proximal and complex in nature 2. More comprehensive classification systems, such as the Strasberg classification that includes non-CBD injuries or the Stewart-Way and Hannover classifications that include vascular injuries, have been described 17 18.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal bile leak after laparoscopic cholecystectomy

et al. 2018

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Bile duct injury (BDI) is a well-recognised complication of laparoscopic cholecystectomy (LC). Following a BDI, bile usually leaks into the peritoneal space and causes biliary peritonitis. This manifests as non-specific abdominal pain and fever occurring several days after the surgery. It can be managed by laparoscopic washout with or without bile duct repair. We present a rare case of retroperitoneal bile leak post-LC. The mechanism of injury here was likely partial avulsion from excessive traction of the cystic duct during intraoperative cholangiogram. Diagnosing retroperitoneal bile leak can be difficult because it is extremely rare and the presenting symptoms can be similar to an intraperitoneal bile leak. A high index of clinical suspicion is required. In cases of suspected bile leak, any mismatch between the exploratory laparoscopic findings and imaging findings should alert surgeons to consider the rare possibility of a retroperitoneal bile leak.

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“…There are arguments that a routine IOC wastes time and money [40][41][42][43]. It has been estimated that if one severe bile duct injury is prevented in every 1000 LCs, the cost of all 'unnecessary' IOCs will be saved [44].…”

Section: Discussionmentioning

confidence: 99%