Minimally invasive biliary anastomosis after iatrogenic bile duct injury: a systematic review

Cubisino, Antonio; Dreifuss, Nicolás H; Cassese, Gianluca; Bianco, Francesco M.; Panaro, Fabrizio

doi:10.1007/s13304-022-01392-5

Cited by 7 publications

(9 citation statements)

References 41 publications

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“…A systematic review of the literature on minimally invasive biliary anastomosis after iatrogenic bile duct injury by Cubisino et al. assessing 12 studies with both laparoscopic and robotic approaches showed that of the 196 patients, 9 had anastomotic strictures with 25% of the robotic and 60% of the laparoscopic cases requiring redoing of the anastomosis 20 . A large retrospective cohort study by Dimou et al.…”

Section: Discussionmentioning

confidence: 99%

“…The high rate of conversion to 'open' operations in laparoscopic extrahepatic biliary resections and reconstructions highlight the difficulty in undertaking these complex operations with multiple anatomical and pathological variability. 20,24 This is also true for BDI, where the robotic approach offers a convenient platform to undertake complex reconstructions, including high injuries on the common hepatic duct, while remaining in a minimally invasive approach. [25][26][27] Though many bile duct pathologies are amenable to endoscopic treatment, there are several situations where operative management is crucial such as obtaining an infectious source control by removing an impacted stone, preventing future malignancies while restoring biliary continuity and ruling out a harbored malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…19 A systematic review of the literature on minimally invasive biliary anastomosis after iatrogenic bile duct injury by Cubisino et al assessing 12 studies with both laparoscopic and robotic approaches showed that of the 196 patients, 9 had anastomotic strictures with 25% of the robotic and 60% of the laparoscopic cases requiring redoing of the anastomosis. 20 A large retrospective cohort study by Dimou et al showed that de novo strictures following biliary-enteric anastomosis are not uncommon, with a rate of 12% at 2 years following biliary-enteric anastomosis. 21 Additionally, a systematic review and meta-analysis by Birgin et al, which included 28 studies and over 6900 patients undergoing biliary-enteric anastomosis, showed a pooled major morbidity (CD ≥ 3b) rate of 26% and a pooled cholangitis rate of 10% at a median time interval of 10 months, with 9% requiring revisional operative management.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…Although minimally invasive surgery has gained immense popularity in recent years for treating various hepatobiliary and pancreatic disorders, it has limitations, especially in complex procedures[ 29 ]. The technical drawbacks related to the laparoscopic approach are an unsteady surgical field, restricted degrees of freedom of movement, a steep learning curve and difficulties in complex suturing[ 30 ]. The complexity of the surgery and the steep learning curve comes from the fact that most patients with BDI would have suffered a bile leak and peritonitis, resulting in extensive adhesions, and altered anatomy[ 30 , 31 ].…”

Section: Limitations Of Minimally Invasive Surgery For Repair Of Post...mentioning

confidence: 99%

“…The technical drawbacks related to the laparoscopic approach are an unsteady surgical field, restricted degrees of freedom of movement, a steep learning curve and difficulties in complex suturing[ 30 ]. The complexity of the surgery and the steep learning curve comes from the fact that most patients with BDI would have suffered a bile leak and peritonitis, resulting in extensive adhesions, and altered anatomy[ 30 , 31 ]. Also, most patients with BDI have complex strictures (Strasberg E3-E5 types).…”

Section: Limitations Of Minimally Invasive Surgery For Repair Of Post...mentioning

confidence: 99%

Minimally invasive surgery for post cholecystectomy biliary stricture: current evidence and future perspectives

Kalayarasan,

Sai Krishna

2023

World J Gastrointest Surg

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Postcholecystectomy bile duct injury (BDI) remains a devastating iatrogenic complication that adversely impacts the quality of life with high healthcare costs. Despite a decrease in the incidence of laparoscopic cholecystectomy-related BDI, the absolute number remains high as cholecystectomy is a commonly performed surgical procedure. Open Roux-en-Y hepaticojejunostomy with meticulous surgical technique remains the gold standard surgical procedure with excellent long-term results in most patients. As with many hepatobiliary disorders, a minimally invasive approach has been recently explored to minimize access-related complications and improve postoperative recovery. Since patients with gallstone disease are often admitted for a minimally invasive cholecystectomy, laparoscopic and robotic approaches for repairing postcholecystectomy biliary stricture are attractive. While recent series have shown the feasibility and safety of minimally invasive post-cholecystectomy biliary stricture management, most are retrospective analyses with small sample sizes. Also, long-term follow-up is available only in a limited number of studies. The principles and technique of minimally invasive repair resemble open repair except for the extent of adhesiolysis and the suturing technique with continuous sutures commonly used in minimally invasive approaches. The robotic approach overcomes key limitations of laparoscopic surgery and has the potential to become the preferred minimally invasive approach for the repair of postcholecystectomy biliary stricture. Despite increasing use, lack of prospective studies and selection bias with available evidence precludes definitive conclusions regarding minimally invasive surgery for managing postcholecystectomy biliary stricture. High-volume prospective studies are required to confirm the initial promising outcomes with minimally invasive surgery.

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Temporal Analysis of the Incidence, Mortality and Disability-Adjusted Life Years of Benign Gallbladder and Biliary Diseases in High-Income Nations, 1990–2019

Proctor,

Goodall,

Borsky

et al. 2024

Annals of Surgery Open

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Objective: The aim of this observational study was to analyze trends in the incidence, mortality, and disability-adjusted life years (DALYs) of benign gallbladder and biliary diseases across high-income countries between 1990 and 2019. Background: Benign gallbladder and biliary diseases place a substantial burden on healthcare systems in high-income countries. Accurate characterization of the disease burden may help optimize healthcare policy and resource distribution. Materials and methods: Age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and DALYs data for gallbladder and biliary diseases in males and females were extracted from the 2019 Global Burden of Disease (GBD) study. A mortality-incidence index (MII) was also calculated. Joinpoint regression analysis was performed. Results: The median ASIRs across the European Union 15+ countries in 2019 were 758/100,000 for females and 282/100,000 for males. Between 1990 and 2019 the median percentage change in ASIR was +2.49% for females and +1.07% for males. The median ASMRs in 2019 were 1.22/100,000 for females and 1.49/100,000 for males with a median percentage change over the observation period of −21.93% and −23.01%, respectively. In 2019, the median DALYs was 65/100,000 for females and 37/100,000 among males, with comparable percentage decreases over the observation period of −21.27% and −19.23%, respectively. Conclusions: International variation in lifestyle factors, diagnostic and management strategies likely account for national and sex disparities. This study highlights the importance of ongoing clinical efforts to optimize treatment pathways for gallbladder and biliary diseases, particularly in the provision of emergency surgical services and efforts to address population risk factors.

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Minimally invasive biliary anastomosis after iatrogenic bile duct injury: a systematic review

Cited by 7 publications

References 41 publications

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

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

Minimally invasive surgery for post cholecystectomy biliary stricture: current evidence and future perspectives

Temporal Analysis of the Incidence, Mortality and Disability-Adjusted Life Years of Benign Gallbladder and Biliary Diseases in High-Income Nations, 1990–2019

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