Laparoscopic Cholecystectomy-Related Bile Duct Injuries

Abstract

Repair of cholecystectomy-related bile duct injuries can run 4.5 to 26.0 times the cost of the uncomplicated procedure and carries a significant mortality rate. Intraoperative recognition of such an injury with immediate conversion to an open procedure for definitive repair can result in significant cost savings and relates directly to a decreased morbidity, mortality, length of hospitalization, and number of outpatient care days.

Biliary tract injuries after lap cholecystectomy—types, surgical intervention and timing

“…Savader et al reviewed in his study the hospital course and charges related to the treatment of 49 patients with bile duct injuries. These patients underwent surgical repair at "The Johns Hopkins Hospital" (37). It was observed in this study that the early BDI recognition immediately at the time of LC had fewer days of hospitalization and less financial costs (37).…”

“…Moreover, a closed suction drain should be left in the subhepatic space. The best option for the patient would be that an experienced surgeon performing the LC will make an immediate repair and minimize the morbidity associated with the injury (32,37). Based on the operative findings the appropriate operative repair will take place.…”

Intraoperative cholangiography in the laparoscopic cholecystectomy era: why are we still debating?

“…It has been described that once an injury occurs, a patient's possible mortality increases to near 18 % [2,3]. In addition to this significant mortality, the monetary cost of BDI repair can be 26 times that of an uncomplicated procedure, which is directly related to the increased morbidity, mortality, length of hospitalization, and number of outpatient care days [46,74].…”

Videothoracoscopic resection for lung cancer: moving towards a “standard of care”

“…The introduction of laparoscopic cholecystectomy led to rapid expansion of the technique. Abdominal surgeons, responding to patient pressure and wanting to retain 'market share' rushed into adoption of the new laparoscopic technique leading to what was seen to be a 'health and financial disaster' (6 least in Europe where lung resection is mainly, or exclusively, carried out by highly trained thoracic surgeons. There will have been accidents in the learning curve no doubt but also adoption was adequately cautious.…”