Management of Segmental Bile Duct Injuries After Cholecystectomy: a Systematic Review

Schizas, Dimitrios; Papaconstantinou, Dimitrios; Moris, Demetrios; Koliakos, Nikolaos; Tsilimigras, Diamantis I.; Bakopoulos, Anargyros; Karaolanis, Georgios; Spartalis, Eleftherios; Dimitroulis, Dimitrios; Felekouras, Evangelos

doi:10.1007/s11605-018-4027-z

Cited by 3 publications

(2 citation statements)

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“…Class IV injuries that involve a sectoral bile duct without transection of the duct can often be managed non-operatively, with drainage and stenting via either ERCP or PTC, with good outcomes in many cases 49–53. Class IV injuries involving transection of the bile ducts require reconstruction of the duct (either the RHD or a right sectoral duct) into a defunctionalized Roux limb.…”

Section: Therapeutic Managementmentioning

confidence: 99%

<p>Iatrogenic bile duct injury: impact and management challenges</p>

Pesce¹,

Palmucci²,

G³

et al. 2019

CEG

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Iatrogenic bile duct injuries (BDIs) after laparoscopic cholecystectomy, being one of the most common performed surgical procedures, remain a substantial problem in gastrointestinal surgery with a significant impact on patient’s quality of life. The primary aim of this review was to discuss the classification of BDIs, the proposed methods to prevent biliary lesions, the associated risk factors, and the management challenges depending on the timing of recognition of the injury, its extension, the patient’s clinical condition, and the availability of experienced hepatobiliary surgeons. Early recognition of BDI is of paramount importance and limiting the diagnosis delay is crucial for an optimal postoperative outcome. The therapeutic management depends on the type and gravity of the biliary lesion, and includes endoscopic, radiologic, and surgical approaches.

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Section: Therapeutic Managementmentioning

confidence: 99%

<p>Iatrogenic bile duct injury: impact and management challenges</p>

Pesce¹,

Palmucci²,

G³

et al. 2019

CEG

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show abstract

“…Benign biliary disease requiring extrahepatic biliary resection and reconstruction in the form of choledochoduodenostomy or Roux-en-Y hepaticojejunostomy is seen in multiple conditions, such as choledochal cysts, iatrogenic bile duct injuries, choledocholithiasis, and biliary strictures. [1][2][3][4] Nonmalignant indications encompass over 60% of all biliary diseases requiring operative management. 5 While the initial management of benign biliary diseases may rely on endoscopic or percutaneous…”

Section: Introductionmentioning

confidence: 99%

The robotic‐assisted laparoscopic approach to biliary tract resection and reconstruction for benign indications: A single‐center experience

Rayman,

Ross,

Pattilachan

et al. 2023

World j. surg.

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BackgroundBenign biliary disease (BBD) is a prevalent condition involving patients who require extrahepatic bile duct resections and reconstructions due to nonmalignant causes.MethodsThis study followed all patients who underwent biliary resections for BBD between 2015 and 2023. We excluded those with malignant conditions and patients who had an ‘open’ operation. Based on the patient's anatomy, the procedures employed were either robotic Roux‐en‐Y hepaticojejunostomy (RYHJ) or robotic choledochoduodenostomy (CDD).ResultsFrom the 33 patients studied, 23 were female, and 10 were male. Anesthesiology (ASA) class was 3 ± 0.5; the MELD score was 9 ± 4.1; the Child‐Pugh score was 6 ± 1.7. The primary indications for undergoing the operation included iatrogenic bile duct injuries, biliary strictures, and type 1 choledochal cysts. The average surgical duration was about 272 min, and the average blood loss amounted to 79 mL. Postoperatively, three patients experienced major complications, all attributed to anastomotic leaks. The average hospital stay was 4 days, with a readmission rate of 15% within 30 days. During an average follow‐up period of 33 months, one patient had to undergo a revision at 18 months due to stricture. This necessitated further duct resection and reanastomosis. Notably, there were no reported hepatectomies, no conversion to the ‘open’ method, no intraoperative complications, and no mortalities.ConclusionsRobotic extrahepatic bile duct resection and reconstruction with Roux‐en‐Y hepaticojejunostomy or choledochoduodenostomy is safe with an acceptable postoperative morbidity, short hospital length of stay, and low postoperative stricture rate at intermediate duration follow‐up.

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