How Do Bile Duct Injuries Sustained During Laparoscopic Cholecystectomy Differ from Those During Open Cholecystectomy?

Chaudhary, Adarsh; Manisegran, M.; Chandra, Abhijit; Agarwal, Ashish; Sachdev, A

doi:10.1089/109264201750539682

Cited by 39 publications

(32 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our observation, type A injury was more common with laparoscopic cholecystectomy whereas type E3 was more common with open cholecystectomy. This contradicts the earlier observation that laparoscopic surgery is associated with severe and more complex BDI [10,11].…”

Section: Discussioncontrasting

confidence: 90%

Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre

et al. 2012

View full text Add to dashboard Cite

The clinical presentation, management and outcome of all patients with bile duct injury who presented to our tertiary care centre at various stages after cholecystectomy were analyzed. The patients were categorized into three groups: group A-patients in whom the injury was detected during cholecystectomy, group B-patients who presented within 2 weeks of cholecystectomy and group C-patients who presented after 2 weeks of cholecystectomy. Our team acted as rescue surgeons and performed 'on-table' repair for injuries occurring in another unit or in another hospital. Strasberg classification of bile duct injury was followed. In group A, partial and complete transections were managed by repair over T-tube and high hepaticojejunostomy, respectively. Patients in group B underwent endoscopic retrograde cholangiogram and/ or magnetic resonance cholangiogram to evaluate the biliary tree. Those with intact common bile duct underwent endoscopic papillotomy and stenting in addition to drainage of intraabdominal collection when present. For those with complete transection, early repair was considered if there was no sepsis. In presence of intra-abdominal sepsis an attempt was made to create controlled external biliary fistula. This was followed by hepatico jejunostomy at least after 3 months. Group C patients underwent hepaticojejunostomy at least 6 weeks after the injury. The outcome was graded into three categories: grade A-no clinical symptoms, normal LFT; grade B-no clinical symptoms, mild derangement of LFT or occasional episodes of pain or fever; grade C-pain, cholangitis and abnormal LFT; grade D-surgical revision or dilatation required. Fifty nine patients were included in the study and the distribution was group A-six patients, group B-33 patients and group C-20 patients. In group A, one patient with complete transection of the right hepatic duct (type C) and partial injury to left hepatic duct (LHD) underwent right hepaticojejunostomy and repair of the LHD over stent. Two patients with type D and three patients with type E 2 injury underwent repair over T-tube and hepaticojejunostomy, respectively. In group B, all except one of the 18 patients with type A injury underwent endoscopic papillotomy and stenting. The bile leak subsided at a mean interval of 8 days in all, except one patient who died of fulminant sepsis. Of the 15 patients with type E injury, five underwent hepaticojejunostomy after a minimum gap of 3 months. Early repair was considered in 10 patients. Twenty patients in group C underwent hepaticojejunostomy. In a mean follow-up of 40 months, the outcome was grade A in 54 patients, grade B in three patients (one from each of the three groups) and grade D in one patient (group C). The latter patient with a type E3 injury developed recurrent stricture and cholangitis necessitating percutaneous transhepatic dilatation. The high success rate of bile duct repair in the present study can be attributed to the appropriate timing, meticulous technique and the tertiary care experience.Keywords Cholecystect...

show abstract

Section: Discussioncontrasting

confidence: 90%

Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In one of the first major multicentre trials Woods et al reported approximately 37% of injuries diagnosed intra-operatively when an IOC was not performed. Walsh, Lillemoe and Chaudhary and their co-workers had 29%-30% intra-operatively diagnosed lesions in their series [72,83,87], while Richardson stated that less than 50% are diagnosed intra-operatively [3]. However, this is a major problem in the management of bile duct injuries because it is a matter of fact that, beside the surgeons experience [88], early diagnosis improves the results [63,89].…”

Section: Diagnosis and Managementmentioning

confidence: 99%

Laparoscopic cholecystectomy: early and late complications and their treatment

Shamiyeh

Wayand

2004

Langenbecks Arch Surg

134

View full text Add to dashboard Cite

show abstract

“…The use of IOC is still controversial, and opinions are split between routine 1,2,3 and selective use. 4 Nevertheless, the incidence of CBD stones is approximately 3.3%, 5 and the detection rate of CBD abnormalities or injuries intraoperatively is reported in the range of 18 to 37%, 6,7,8 suggesting that biliary complications might be detected earlier and more frequently with its routine use. 6 In addition, early diagnosis of stones and injuries is reported to improve treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

Real-time intraoperative assessment of the extrahepatic bile ducts in rats and pigs using invisible near-infrared fluorescent light

Tanaka

Choi

Humblet

et al. 2008

Surgery

View full text Add to dashboard Cite

show abstract

How Do Bile Duct Injuries Sustained During Laparoscopic Cholecystectomy Differ from Those During Open Cholecystectomy?

Cited by 39 publications

References 18 publications

Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre

Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre

Laparoscopic cholecystectomy: early and late complications and their treatment

Real-time intraoperative assessment of the extrahepatic bile ducts in rats and pigs using invisible near-infrared fluorescent light

Contact Info

Product

Resources

About