Failed primary management of iatrogenic biliary injury: Incidence and significance of concomitant hepatic arterial disruption

Koffron, Alan J.; Ferrario, M.; Parsons, Willis G.; Nemcek, Albert A.; Saker, Mark B.; Abécassis, Michaël

doi:10.1067/msy.2001.116682

Cited by 123 publications

(116 citation statements)

References 20 publications

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“…10,11,14 While arterial injury may be considered an indication to delay repair given concern for biliary or bilioenteric anastomotic structure, 8,10,11,22,23 liver transplantation may be required for catastrophic vasculobiliary injuries. 11,14,24 The present series includes 4 patients with VBI who underwent early repair: three tangential hepatic vascular injuries requiring intervention to prevent ongoing hemorrhage and a single extreme VBI with segmental portal vein and proper hepatic artery excision.…”

Section: Discussionmentioning

confidence: 99%

Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity

Kirks

Barnes

Lorimer

et al. 2016

HPB

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Section: Discussionmentioning

confidence: 99%

Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity

Kirks

Barnes

Lorimer

et al. 2016

HPB

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“…The hepatic vasculature and the biliary tree may be injured during cholecystectomy (Lillemoe et al 1997;Nishio et al 1999;Erkan et al 2001;Koffron et al 2001;Buell et al 2002;Bilge et al 2003). Although bile duct injury is more common, detailed studies show that "silent" concomitant arterial injury may be detected in patients with bile duct injury (Erkan et al 2001;Koffron et al 2001;Nordin et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

Öncel

Özden

Bilge

et al. 2006

Tohoku J. Exp. Med.

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“…The number of iatrogenic biliary injuries has recently risen two fold, and is associated with the spread of laparoscopic cholecystectomy. Actually, the frequency of biliary injuries is 0.2% during laparoscopic cholecystectomy and is 0.1% during open cholecystectomy (3)(4)(5)(6). The cholecystectomy was also the most frequent cause of iatrogenic biliary injuries in the presented material.…”

Section: Discussionmentioning

confidence: 87%

“…The blood supply disturbances may be caused by injuries of the 3 o'clock and 9 o'clock axial arteries, which are the source of extrahepatic biliary tract vascularization. Injuries of the proper hepatic artery within the hepatoduodenal ligament also may be the cause of the biliary stricture (8,9). The symptoms of interruption of common bile or hepatic duct continuity usually appear within several days following the trauma procedure.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Iatrogenic Biliary Injuries - Early Complications

Jabłońska¹,

Lampe²,

Lekstan³

et al. 2008

Polish Journal of Surgery

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The aim of the study was the analysis of early complications following different methods of surgical treatment for iatrogenic biliary injury (IBI). Material and methods. From January 1990 to March 2005, 138 patients with iatrogenic biliary injuries were operated on in the Department of Gastrointestinal Surgery of Silesian Medical University in Katowice. The most frequent iatrogenic biliary injuries were caused by open and laparoscopic cholecystectomy. Clinical symptoms in patients included the following: pain, jaundice, pruritus, nausea, vomitus and cholangitis signs. The following diagnostic examinations were performed before surgical procedures: laboratory investigations and radiological examinations -including ultrasonography of the abdominal cavity, cholangiography, endoscopic retrograde cholangiopancreatography, computed tomography and magnetic resonance-cholangiography. The level of biliary injury was classified according to Bismuth. The following reconstruction methods were performed: Roux-Y hepaticojejunostomy in 49 patients, endto-end ductal anastomosis in 45 patients, jejunal interposition hepaticoduodenostomy in 27 patients, bile duct plastic reconstruction in 6 patients, choledochoduodenostomy in 2 patients and other methods in 8 patients.Results. The mean duration of hospitalization was 31 days. The mean duration of operation was 4.5 hours. Early complications were observed in 22 (16%) patients. The following early complications were noted: bile collection in 11 patients, intra-abdominal abscess in 4, wound infection in 13, peritonitis in 2, cholangitis in 2, eventeration in 1, pneumonia in 7 and acute circulatory insufficiency in 3 patients. Seven (5%) early re-operations were performed: 2 due to biliary-enteric anastomosis dehiscence, 1 due to eventeration, and 4 due to bile collection or intra-abdominal abscess. Three (2%) hospital deaths were noted: 1 due to due acute circulatory insufficiency, 1 due to liver necrosis and acute respiratory and circulatory insufficiency, and 1 due to biliary-enteric anastomosis dehiscence, bile collection, peritonitis, and acute circulatory and respiratory insufficiency. Conclusions. Surgical reconstructions of iatrogenic biliary injuries are procedures that require maximal precision and knowledge of different methods of reconstruction of biliary tract continuity. The choice of the method depends on the situation in the operation area. In treatment centers experienced in iatrogenic biliary injuries, early complications occur in 16% of surgical patients. Mortality does not exceed 2% of surgical patients.

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Failed primary management of iatrogenic biliary injury: Incidence and significance of concomitant hepatic arterial disruption

Cited by 123 publications

References 20 publications

Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity

Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity

Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

Surgical Treatment of Iatrogenic Biliary Injuries - Early Complications

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