Laparoscopic hepaticojejunostomy after bile duct injury

Cuendis-Velázquez, Adolfo; Morales-Chávez, Carlos Ernesto; Aguirre-Olmedo, Itzé; Torres-Ruiz, Fernanda; Rojano-Rodríguez, Martín Edgardo; Fernández-Álvarez, Luis; Cárdenas-Lailson, Eduardo; Moreno-Portillo, Mucio

doi:10.1007/s00464-015-4282-y

Cited by 33 publications

(22 citation statements)

References 29 publications

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“…Similarly, Laukkarinen et al, 2010 [ 69 ], found low rates of anastomotic leakage or stricture in their experimental models when performed Roux-en-Y HJ with a transanastomotic stents, also, Moris et al, 2016 [ 70 ] recorded low stricture rate when performed HJ with stenting for biliary obstruction of different causes. On contrary, the outcome of Roux-en-Y HJ that was performed laparoscopically by Cuendis-Vela´zquez et al, 2016 [ 7 ] was good at maximum 36 months follow-up without using stents.…”

Section: Discussionmentioning

confidence: 99%

“…The use of trans-anastomotic stents is controversial [ 2 , 7 , 15 , 67 ]. However, some investigators reported the benefit of stents in avoiding recurrent cholangitis [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite increased surgical skills and experience regarding laparoscopic choelcystectomy (LC), the rate of LC related bile duct injury (BDI) is still higher in comparison to open cholecystectomy (0.2%–1.5% vs. 0.1–0.2% respectively) [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] ]. LC related BDIs range from minor injuries to complex hilar injuries as classified by Strasberg et al [ 9 , 10 ]; where the major types correspond to type E injuries including ongoing stricture, complete occlusion, resection or division of the bile ducts; [ [11] , [12] , [13] ].…”

Section: Introductionmentioning

confidence: 99%

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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%

“…The use of trans-anastomotic stents is controversial [ 2 , 7 , 15 , 67 ]. However, some investigators reported the benefit of stents in avoiding recurrent cholangitis [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Emerging data come from the evaluation of minimal invasive approaches to perform HJ, even in severe BDI injuries. In the laparoscopic setting, it was recently showed that laparoscopic approach to BDI repair is feasible and safe with low morbidity rates (bile leak, 17.2%, reintervention, 6.8%) accompanied with the well-established advantages of laparoscopic surgery (low pain, earlier mobilization, and cosmesis) [ 38 ]. In the setting of malignancies, the results are not that satisfactory since the morbidity rate reached 33.3% and mortality was 2.08% in a series of laparoscopic HJ cases for palliative treatment of pancreatic head malignancy [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis

Moris

Papalampros

Vailas

et al. 2016

Gastroenterology Research and Practice

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Roux-en-Y hepaticojejunostomy (RYHJ) is currently considered as the definitive treatment for iatrogenic bile duct injuries and the principal representative of biliary diversion procedures. This technique has met many milestones of extensive evolution, particularly the last years of concomitant technological evolution (laparoscopic/robotic approach). Anastomotic strictures and leaks, which may have deleterious effects on the survival and quality of life of a patient with biliary obstruction of any cause, made the need of the development of a safe and efficient RYHJ compulsory. The aim of this technical analysis and the juxtaposed discussions is to elucidate with the most important milestones and technical tips and tricks all aspects of a feasible and reliable RYHJ technique that is performed in our center for the last 25 years in around 400 patients.

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“…Similarly, evidence on late repair of biliary strictures by laparoscopic hepaticojejunostomy is scarce. Long term follow-up of these patients is not known (63,64). Laparoscopic repair of biliary strictures should only be considered in research protocols in highly specialized centers.…”

Section: D) Can Biliary Injuries Be Repaired Laparoscopically?mentioning

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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Laparoscopic hepaticojejunostomy after bile duct injury

Abstract: The benefits of minimally invasive approaches in BDI seem to be feasible and safe, even when this is a complex and catastrophic scenario.

Cited by 33 publications

References 29 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

The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis

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

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