Relaparoscopy in Minor Bile Leakage After Laparoscopic Cholecystectomy

Barband, Ali Reza; Kakaei, Farzad; Daryani, Amir; Fakhree, M. Bassir A.

doi:10.1097/sle.0b013e31822a2373

Cited by 19 publications

(21 citation statements)

References 18 publications

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“…Objectively, they may show evidence of obstructive jaun dice, sepsis, or documented bile leakage. 1,2,5 For patients with bile peritonitis, it is important to implement a rigorous workup, including cholangiography via magnetic resonance cholangiopancreatography (MRCP), percutaneous trans hepatic cholangiography (PTC), or endoscopic retrograde cholangiopancreatography (ERCP). Likewise, control of bilomas or bile peritonitis is imperative.…”

Section: Postoperative Presentationmentioning

confidence: 99%

“…5,[7][8][9] Returning to the operating room early following surgery allows for the drainage of a biloma or intraabdominal collection, clipping of any acces sory ducts or an insecure cystic duct, inspection of the bili ary anatomy with potential treatment (i.e., releasing a clipped CBD), or placement of a drain to control the leak conservatively. We discuss this topic in further detail below, in the management section.…”

Section: Postoperativementioning

confidence: 99%

“…9 The first step at relaparoscopy is to perform extensive washout of the abdominal cavity to help control and treat the sepsis and to allow for identification of the source of the bile leak. 5,7 Although the most likely source is somewhere in the biliary tree, the small bowel and, in particular, the duodenum should be inspected to rule out inadvertent injury there, which could give rise to a similar presentation.…”

Section: Relaparoscopymentioning

confidence: 99%

“…5,7 Endoscopic retrograde cholangiopan creatography and sphincterotomy, with or without bili ary stenting, can help to ensure low pressure in the bili ary tract, which will allow the defect to seal itself with time. There are several reports of leaks from small ducts in the gallbladder bed, the duct of Luschka, or small accessory hepatic ducts being successfully controlled with laparoscopic suturing.…”

Section: Relaparoscopymentioning

confidence: 99%

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Role for laparoscopy in the management of bile duct injuries

Gupta

Jayaraman

2017

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Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the manage ment of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and manage ment, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques. When CBD injury is suspected postoperatively, repeat laparoscopy can be used to control sepsis with abdominal washout; as a diagnostic tool to guide management; and, in some settings, as a therapeutic tool for suturing small duct leaks, drain insertion and postoperative endoscopic retrograde cholangiopancreatography with sphincterotomy. Definitive laparoscopic repair is possible when certain criteria are met. Open surgery should be considered when the CBD is small, the injury occurred more than 72 hours previ ously, injury or anatomy are complex, port positioning is awkward for repair, or local experience is limited with laparoscopic management. There is an emerging role for laparoscopy in the management of CBD injuries. More case reports and series are needed to show the safety and efficacy of this technique, encourage its wider adoption, and allow outcomes assessment on a larger scale.La lésion du canal cholédoque est la plus grave complication de la cholécystectomie laparoscopique. Récemment, des techniques laparoscopiques ont été utilisées pour traiter les fuites biliaires postopératoires et les lésions du canal cholédoque; la littéra ture à ce sujet n'a pas été passée en revue. Nous avons donc entrepris de faire une revue de la littérature publiée sur les lésions du canal cholédoque, les approches diag nostiques et thérapeutiques les concernant, ainsi que des rapports sur les approches thérapeutiques laparoscopiques. Nous avons combiné cette revue à notre expérience des méthodes laparoscopiques pour mettre en lumière les options diagnostiques et thérapeutiques. Il est possible d'utiliser des techniques laparoscopiques pour prévenir, diagnostiquer et traiter les lésions du canal cholédoque. Durant une intervention, on peut prévenir la lésion du canal cholédoque, dans le cas d'un canal cystique court, en recourant à des boucles de fil préformées ou à des sutures par transfixion; et la lésion peut être diagnostiquée par cholangiographie ou autre technique d'imagerie per opératoires. Lorsqu'on soupçonne une lésion du canal cholédoque en postopératoire, on peut répéter la laparoscopie pour vérifier la présence d'infection et procéder à un lavage abdominal, comme outil diagnostique pour guider le traitement et, dan...

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Section: Postoperative Presentationmentioning

confidence: 99%

Section: Postoperativementioning

confidence: 99%

Section: Relaparoscopymentioning

confidence: 99%

Section: Relaparoscopymentioning

confidence: 99%

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Role for laparoscopy in the management of bile duct injuries

Gupta

Jayaraman

2017

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“…It usually takes 3‐12 days for the bile leakage to disappear after endoscopic treatment . Some studies have shown that some patients who underwent relaparoscopy selectively had a shorter hospital stay than those who underwent ERCP as the intervention …”

Section: Discussionmentioning

confidence: 99%

Peritonitis from injury of an aberrant subvesical bile duct during laparoscopic cholecystectomy: A rare case report

Song

2018

Clinical Case Reports

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Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

Guerra

Coletta

Gavioli

et al. 2020

J Hepato Biliary Pancreat

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Background In recent years there has been a growing interest in the application of minimally invasive surgery in the management of cholecystectomy‐related injury to the biliary tract. The aim of this analysis was to identify and combine the available evidence on the argument, with particular reference to major injuries to the main bile duct requiring biliodigestive anastomosis. Methods The PubMed/MEDLINE, Embase, and Web of Science electronic databases were queried through May 2019. Inclusion criteria considered all studies reporting detailed data about patients with bile duct injury following cholecystectomy receiving minimally invasive (both laparoscopic and robotic) surgical repair. Clinical outcomes data were pooled and analyzed. Results A total of 31 studies reporting on the outcomes of 218 patients were eventually included in the analysis, whereby 148 patients with type D or E injury. Of these, there were 31 patients (21%) receiving direct bile duct repair and 117 patients (79%) undergoing bilioenteric reconstruction. Among patients with major bile duct injury, postoperative morbidity was 24%, being 12% the incidence of major complications and 6% the rate of patients requiring subsequent, further surgery. Conclusions The absence of high‐level evidences precludes the possibility to draw definitive conclusions. However, the available data derived from a growing number of centers demonstrate that minimally invasive surgery may offer its well‐known advantages on postoperative outcomes also in the setting of severe iatrogenic injury to the bile ducts.

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Relaparoscopy in Minor Bile Leakage After Laparoscopic Cholecystectomy

Abstract: Relaparoscopy is an effective procedure in the management of minor bile leakage after laparoscopic cholecystectomy and can be an alternative approach in selected situations.

Cited by 19 publications

References 18 publications

Role for laparoscopy in the management of bile duct injuries

Role for laparoscopy in the management of bile duct injuries

Peritonitis from injury of an aberrant subvesical bile duct during laparoscopic cholecystectomy: A rare case report

Minimally invasive surgery for the management of major bile duct injury due to cholecystectomy

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