Liver transplantation for iatrogenic bile duct injury during cholecystectomy: a French retrospective multicenter study

Liver transplantation for the treatment of iatrogenic bile duct injury

“…Rev Col Bras Cir 49:e20223436 Zeni Liver transplantation for the treatment of iatrogenic bile duct injury (0.06%) were related to BDI. The rate of LT for BDI was 0.13% (30 out of 23,329 LT) in 11 French LT centers 25 . In Buenos Aires, Argentina, de Santibañes et al 12 described the highest rate, 2.4% (16 out of 663 LT).…”

“…In addition, the rate of lawsuits is quite expressive 12,23,24 . About 80% to 90% of BDI occur in patients undergoing cholecystectomy 13,25 . Currently, the rate of BDI is similar in patients undergoing open or laparoscopic cholecystectomy and varies between 0.1% and 0.6% 4,12,26,27 .…”

“…The presence of extensive adhesions resulting from previous surgeries to correct the BDI, combined with liver cirrhosis, portal hypertension, and biliary infection caused by resistant bacteria, make LT an enormous surgical challenge in patients with BDI 23,25 . The duration of the operation and the operative bleeding are extensive, even when LT is performed in a referral center 13,23,25 . Some authors have shown that the operative mortality and morbidity rates of LT in patients with BDI are much higher than for other indications 19,25 .…”

Comment on: “Liver transplantation for iatrogenic bile duct injury during cholecystectomy: a French retrospective multicenter study”

“…We read with great interest the national retrospective multicenter observational study recently published by Chiche and collaborators ( 1 ) aiming to review liver transplants related to iatrogenic bile duct injury (BDI) during cholecystectomy and the risk factors for adverse outcomes in order to improve management of BDI. In this study, all liver transplantation (LT) patients between 1994 and 2017 for BDI during cholecystectomy were included.…”

Iatrogenic Bile Duct Injury: Call for Help, Refer Early, Reduce Infection. Invited Commentary: Liver Transplantation as Definitive Treatment of Postcholecystectomy Bile Duct Injury: Experience in a High-volume Repair Center

“…9,10 However, the diagnosis of SBC is not made until 9 to 11 years later. 1,11 Seeking a higher level of care for these patients has a two-fold objective: 1) introducing the patient into a practice that is more experienced with these type of complex problems and has the technical and medical expertise to deal with them -namely, interventional radiology, advanced interventional gastroenterology, and infectious disease experts; and 2) damage control, by providing some objectivity in bringing in a neutral provider team that is not as emotionallyinvested in this devastating event for the patient and the surgeon. In IBDI, the success of a second or even third operation is known to be subsequently lower with each intervention 12,13 and thus early referral to a hepatobiliary specialist is in the interest of the patient to ensure the repair is poised for success and halt the pathway to SBC.…”