Spontaneous postoperative choledochoduodenal fistula due to bile duct injury following laparoscopic cholecystectomy

Yılmaz, Sezgin; Akıcı, Murat; Okur, Nazan; Türel, Serkan; Erşen, Ogün; Şahin, Enes

doi:10.1016/j.ijscr.2016.06.040

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…BDI is considered the most significant complication of LC [ 9 , 20 , 47 ]. The rate of MBDI (type E) of Strasberg's classification vary from 0.08 to 0.6% and is associated with significant morbidity and mortality [ 2 , 17 , 18 , 31 , 48 , 49 ]. Most of the patients with these injuries are referred to tertiary referral centers; either immediately or after unsuccessful re-operation [ 27 , 31 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of laparoscopic cholecystectomy (LC) related major bile duct injuries; predictors of short-and long-term outcomes in a tertiary Egyptian center- a retrospective cohort study

Gad

Ayoup

Kamel

et al. 2018

Annals of Medicine and Surgery

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ObjectivesLaparoscopic cholecystectomy - associated bile duct injury is a clinical problem with bad outcome. The study aimed to analyze the outcome of surgical management of these injuries.Patients and methodsWe retrospectively analyzed 69 patients underwent surgical management of laparoscopic cholecystectomy related major bile duct injuries in the period from the beginning of 2013 to the beginning of 2018.ResultsRegarding injury type; the Leaking, Obstructing, leaking + obstructing, leaking + vascular, and obstructing + vascular injuries were 43.5%, 27.5%, 18.8%, 2.9%, and 7.2% respectively. However, the Strasberg classification of injury was as follow E1 = 25, E2 = 32, E3 = 8, and E4 = 4. The definitive procedures were as follow: end to end biliary anastomosis with stenting, hepaticojejunostomy (HJ) with or without stenting, and RT hepatectomy plus biliary reconstruction with stenting in 4.3%, 87%, and 8.7% of patients respectively. According to the time of definitive procedure from injury; the immediate (before 72 h), intermediate (between 72 h and 1.5months), and late (after1.5 months) management were 13%, 14.5%, and 72.5% respectively. The hospital and/or 1month (early) morbidity after definitive treatment was 21.7%, while, the late biliary morbidity was 17.4% and the overall mortality was 2.9%, on the other hand, the late biliary morbidity-free survival was 79.7%. On univariate analysis, the following factors were significant predictors of early morbidity; Sepsis at referral, higher Strasberg grade, associated vascular injury, right hepatectomy with biliary reconstruction as a definitive procedure, intra-operative bleeding with blood transfusion, liver cirrhosis, and longer operative times and hospital stays. However, the following factors were significantly associated with late biliary morbidity: Sepsis at referral, end to end anastomosis with stenting, reconstruction without stenting, liver cirrhosis, operative bleeding, and early morbidity.ConclusionSepsis at referral, liver cirrhosis, and operative bleeding were significantly associated with both early and late morbidities after definitive management of laparoscopic cholecystectomy related major bile duct injuries, so it is crucial to avoid these catastrophes when doing those major procedures.

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Section: Discussionmentioning

confidence: 99%

Surgical management of laparoscopic cholecystectomy (LC) related major bile duct injuries; predictors of short-and long-term outcomes in a tertiary Egyptian center- a retrospective cohort study

Gad

Ayoup

Kamel

et al. 2018

Annals of Medicine and Surgery

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“…Spontaneous choledochoduodenal fistula due to iatrogenic bile duct injury during laparoscopic cholecystectomy is rare. 6 Gastrointestinal bleeding may be one of the manifestations of choledochoduodenal fistula. 5 However, to the best of our knowledge, pseudoaneurysm adjacent to choledochoduodenal fistula following laparoscopic cholecystectomy has not been previously reported.…”

Section: Discussionmentioning

confidence: 99%

A Challenging Case of Postcholecystectomy Pseudoaneurysm at an Uncommon Location

Choudhary

Bhujade

Gupta

et al. 2022

Journal of Clinical Interventional Radiology ISVIR

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Hepatic artery pseudoaneurysm in postcholecystectomy choleduodenal fistula is an extremely rare but clinically significant complication. A 52-year-old male presented with hematemesis and melena several weeks after open cholecystectomy for complicated gallstone disease. Upper gastrointestinal endoscopy revealed bleeding from the choledochoduodenal fistula site. On computed tomography angiography, a small right hepatic artery pseudoaneurysm close to fistula site was identified. Endovascular embolization failed due to nonopacification of the proximal right hepatic artery. Endoscopic ultrasound-guided embolization was also unsuccessful due to the small size of the aneurysm and inadequate visualization. Following this, percutaneous n-butyl cyanoacrylate glue was successfully injected into the pseudoaneurysm. The patient recovered and was planned for hepaticojejunostomy to restore biliary continuity.

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“…A case reported by Yilmaz et al [9] presented a spontaneous choledochoduodenal fistula after bile duct injury following laparoscopic cholecystectomy. However, this fistula formed due to the inflammation caused by bile leak.…”

Section: Discussionmentioning

confidence: 99%

“…The patient presented by Macedo et al [10] received elective biliary reconstruction under the same rationale. The patient presented by Yilmaz et al [9] was left untreated for the fistula because she was asymptomatic, but returned with recurrent cholangitis symptoms due to fistula stricture requiring surgery.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous choledochoduodenal fistula in a patient with a bile duct injury following laparoscopic cholecystectomy

Gallagher

Imagawa

2019

Journal of Surgical Case Reports

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We report a 67-year-old female that had a laparoscopic cholecystectomy complicated by common bile duct (CBD) and right hepatic artery injuries. A catheter was placed into the proximal common bile duct to create an external biliary fistula. The catheter eroded into the edge of the CBD and that irritation caused a choledochoduodenal fistula to form. To our knowledge, this is the first reported case in which an external biliary catheter caused the formation of a choledochoduodenal fistula after a bile duct injury from a laparoscopic cholecystectomy.

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Spontaneous postoperative choledochoduodenal fistula due to bile duct injury following laparoscopic cholecystectomy

Cited by 7 publications

References 11 publications

Surgical management of laparoscopic cholecystectomy (LC) related major bile duct injuries; predictors of short-and long-term outcomes in a tertiary Egyptian center- a retrospective cohort study

Surgical management of laparoscopic cholecystectomy (LC) related major bile duct injuries; predictors of short-and long-term outcomes in a tertiary Egyptian center- a retrospective cohort study

A Challenging Case of Postcholecystectomy Pseudoaneurysm at an Uncommon Location

Spontaneous choledochoduodenal fistula in a patient with a bile duct injury following laparoscopic cholecystectomy

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