Intraoperative Management and Repair of Bile Duct Injuries Sustained during 10,123 Laparoscopic Cholecystectomies in a High-Volume Referral Center

Pekolj, Juan; Alvarez, Fernando A.; Palavecino, Martín; Clariá, Rodrigo Sanchez; Mazza, Oscar; Santibañés, Eduardo de

doi:10.1016/j.jamcollsurg.2013.01.051

Cited by 119 publications

(92 citation statements)

References 28 publications

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“…Bile duct injury incidence remains low but precise In case of intraoperative diagnosis, before immediate repair, complete assessment of biliary tract anatomy with IOC is mandatory, either by an open or by laparoscopic approach (5). A conversion to laparotomy is required if the operator's experience is limited, or if the anatomy is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…A conversion to laparotomy is required if the operator's experience is limited, or if the anatomy is unclear. An HPB surgeon should be involved in the management and repair as outcomes are significantly better (5,11,12). For minor A lesion, applying a clip or a ligature combined with a transcystic drainage is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the absence of randomized controlled trials showing significant benefit of laparoscopic approach, it has now become the gold standard for more than 3 decades in the treatment of symptomatic cholelithiasis. Increased incidence of iatrogenic bile duct injuries (BDI) was reported, about 0.3% against 0.2% in laparotomy (5,6). The study aim was to analyze incidence and management strategies of these lesions in a single teaching center.…”

Section: Introductionmentioning

confidence: 99%

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Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Martin¹,

Uldry²,

Demartines³

et al. 2016

BST

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Martin¹,

Uldry²,

Demartines³

et al. 2016

BST

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“…Laparotomy should be avoided as this may further complicate the injury (60). Placing a subhepatic drain and constituting contact with the center before referral is beneficial.…”

Section: C) What Is the Management Of Biliary Injuries Diagnosed Intrmentioning

confidence: 99%

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Abbasoğlu¹,

Tekant²,

Alper³

et al. 2016

UCD

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Gallstone disease is very common and laparoscopic cholecystectomy is one of the most common surgical procedures all over the world. Parallel to the increase in the number of laparoscopic cholecystectomies, bile duct injuries also increased. The reported incidence of bile duct injuries ranges from 0.3% to 1.4%. Many of the bile duct injuries during laparoscopic cholecystectomy are not due to inexperience, but are the result of basic technical failures and misinterpretations. A working group of expert hepatopancreatobiliary surgeons, an endoscopist, and a specialist of forensic medicine study searched and analyzed the publications on safe cholecystectomy and biliary injuries complicating laparoscopic cholecystectomy under the organization of Turkish Hepatopancreatobiliary Surgery Association. After a series of e-mail communications and two conferences, the expert panel developed consensus statements for safe cholecystectomy, management of biliary injuries and medicolegal issues. The panel concluded that iatrogenic biliary injury is an overwhelming complication of laparoscopic cholecystectomy and an important issue in malpractice claims. Misidentification of the biliary system is the major cause of biliary injuries. To avoid this, the "critical view of safety" technique should be employed in all the cases. If biliary injury is identified intraoperatively, reconstruction should only be performed by experienced hepatobiliary surgeons. In the postoperative period, any deviation from the expected clinical course of recovery should alert the surgeon about the possibility of biliary injury.

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“…The formation of gallstones in the gall bladder is very common (1)(2)(3)(4)(5)(6). It is now considered that approximately 10% to 15% of the adult population has gallstones.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic Injury to the Common Bile Duct

Buturovic¹

2014

Med Arh

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Introduction:The formation of gallstones in the gall bladder is very common. It is now considered that approximately 10% to 15% of the adult population has gallstones. It is more frequent in women than men. Etiologies are various and include: age, sex, diet, sudden weight loss, etc. According to the report of the US National Institute of Health, it is estimated that 6.3 million men and 14.2 million women, aged 20-74 years in the United States has calculosis of the gallbladder, due to which every year is performed about 700,000 cholecystectomy. Case report: Male patient, aged about 40 years, admitted at the Clinic and laparoscopic surgery was performed in our department for chronic, as multiple, symptomatic gallbladder calculi. Intraoperative findings showed chronically inflamed, curled gall bladder, and wall thickening. After the first postoperative day there is no content in the drain bag and it is taken out, and the patient leaves the hospital without any problems. The seventh post-operative day occurred abdominal pain, weakness and fatigue, with striking yellow skin and visible mucous membranes. Clinical, laboratory and echo determined abdomen full of fluids, so it was suspected lesion of the bile duct. Urgent revision was performed. Intraoperative was found a lesion of the common bile duct in the form of a complete interruption. Created is anastomosis through transhepatic drain according to Pradera. Early and late postoperative flow was entirely normal with normal laboratory and echofindings. Control, contrast imaging through a drain showed the orderly flow of extrahepatic bile ducts, with minimal extravasation of contrast. Conclusion: At the Department of Surgery of General Hospital in Konjic laparoscopic cholecystectomy is performed since 1999. In the beginning it was done by three trocars (European style), and later, in order to prevent complications or injury of the bile duct is performed surgery with four trocars (American style). The number of complicated procedures in our hospital does not differ from similar indicators in foreign surgical facilities.

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Intraoperative Management and Repair of Bile Duct Injuries Sustained during 10,123 Laparoscopic Cholecystectomies in a High-Volume Referral Center

Cited by 119 publications

References 28 publications

Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Iatrogenic Injury to the Common Bile Duct

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