Management of major postcholecystectomy biliary injuries: An analysis of surgical results in 62 patients

Shetty, Sushruth; Desai, Premal R; Vora, Hasmukh B; Bhavsar, Mahendra S; Khiria, Lakshman S.; Yadav, Ajay; Jillawar, Nikhil

doi:10.4103/njs.njs_35_18

Cited by 5 publications

(1 citation statement)

References 16 publications

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“…[1,23,24] Roux-Y HJ is usually preferred as surgical procedure. [25,26] However, depending on the type of injury, more complicated procedures like Kasai can also be performed. [27] Results are more promising if there is a not complete cut in CBD and evidence of diffuse peritonitis.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Acar

Güngör

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Iatrogenic biliary tract injury (BTI) is a rare complication but has high risks of morbidity and mortality when it is not early noticed. Although the treatment varies depending on the size of injury and the time until the injury is noticed, endoscopic and percutaneous interventions are usually sufficient. However, it should be remembered that these interventions may cause major complications in the following years, such as biliary stricture, recurrent episodes of cholangitis and even cirrhosis. In this paper, we aimed to present our approach to BTI following cholecystectomy and our treatment management in the light of the literature. METHODS:The medical records of 105 patients who were treated for BTI between January 2015 and July 2019 were evaluated retrospectively. The majority of the patients consisted of the patients who underwent cholecystectomy at an external medical center and were referred to our clinic due to biliary leakage (BL). Patients were grouped according to Strasberg classification determined by the place of leakage. RESULTS:Among 105 patients included in this study, 55 were male, and 50 were female. Mean age was 55.2 ±16.26 years (range, 21-93 years). According to Strasberg classification, type A, B, C, D and E injuries were detected in 57, 1, 3, 29 and 15 patients, respectively. Eighty-five patients were successfully treated with endoscopic and percutaneous interventions, while 20 patients underwent surgery. CONCLUSION:In all patients with suspected BTI, a detailed screening and appropriate treatment provide a significant decline in morbidity and mortality. Therefore, early diagnosis is very important for both early and late outcomes.

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Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Acar

Güngör

et al. 2020

Ulus Travma Acil Cerrahi Derg

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Operative timing and the safety of emergency laparoscopic cholecystectomy: A retrospective analysis

Li,

Xu,

Tian

et al. 2023

Medicine

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The ideal operative timing for laparoscopic cholecystectomy (LC) remains controversial, particularly in emergency patients. This study aimed to evaluate the necessity of operative timing for emergency LC. One hundred ninety-four patients who had undergone operative timings were classified into groups of <72h and >72h from the onset of symptoms to the operation. Baseline data, basic disease, operative bleeding, complications, and conversion rates were analyzed by Variance analysis and logistic regression analysis. The total morbidity of postoperative complication was 4.93% and 3.84% (P = .751) in the <72h and >72h groups respectively. The complication and conversion to LC were mainly influenced by age and gallbladder volume (odds ratio [OR] = 1.078, P = .013, and OR = 1.035, P = .031), but not by operative timing (P = .292). The intraoperative blood loss was closely correlated with the gallbladder volume (OR = 1.019, P = .025) by logit regression analysis, and correlation coefficient of R = 0.436, P < .01. Our results suggest that it is not necessary to confine the operative timing of LC to within 72h from the onset of symptoms, and gallbladder volume should be emphasized in the operative timing for emergency LC.

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Bile duct injuries after cholecystectomy, analysis of constant risk

Díaz-Martínez

Chapa-Azuela

Roldán-García

et al. 2020

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims: The bile duct injuries are the most severe complications that occur after the surgical manipulation of the bile duct. The hepaticojejunostomy remained as the best treatment. Several factors identified that affect the result. This study aimed to analyze and identify risk factors that affected the evolution of these patients. Methods: A retrospective, observational study was conducted from February 1998 to June 2017. We included all patients with bile duct injuries who required surgical treatment. Results: We found 79 patients. The majority had a Bismuth type III in 35.4% (n=28). The morbidity of the Hepaticojejunostomy was 19% (n=15). In short-term follow-up, the main complications were cholangitis 11.4% (n=9) and bile leak 10% (n=8). In the long-term follow-up, in 2.5% (n=2) stricture was presented. On the comparison between postoperative and preoperative parameters, biliary peritonitis after a cholecystectomy (p=0.02) was an independent predictor of postoperative morbidity (p＜0.05). Conclusions: In the treatment of bile duct injuries, different factors affect their outcomes. Our results show that infectious complications continue to affect the results of the treatment of bile duct lesions.

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Management of major postcholecystectomy biliary injuries: An analysis of surgical results in 62 patients

Cited by 5 publications

References 16 publications

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Operative timing and the safety of emergency laparoscopic cholecystectomy: A retrospective analysis

Bile duct injuries after cholecystectomy, analysis of constant risk

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