Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Rystedt, Jenny; Kleeff, Jörg; Salvia, Roberto; Besselink, Marc G.; Prasad, Raj; Lesurtel, Mickaël; Sturesson, Christian; Hilal, Mohammed Abu; Aljaiuossi, Anas; Antonucci, Adelmo; Ardito, Francesco; Ausania, Francesco; Bernon, M.; Berrevoet, Frederik; Björnsson, Bergþór; Bonsing, Bert A.; Boonstra, Elizabeth A.; Bracke, B.; Brusadín, Roberto; Burda, L; Caraballo, M.; Casellas-Robert, Margarida; Çöker, Ahmet; Davide, Josè; Gelder, A. De; Rose, Agostino Maria De; Djokić, Mihajlo; Dudek, Krzysztof; Ekmekcigil, Ela; Filauro, Marco; Fülöp, András; Gallagher, Tom K.; Gastaca, Mikel; Gefen, Rachel; Giuliante, Felice; Habibeh, Hussein; Halle‐Smith, James; Haraldsdóttir, Kristín; Hartman, V.; Hauer, A.; Hemmingsson, Oskar; Hoskovec, David; Isaksson, Bengt; Jonas, Eduard; Khalaileh, A.; Klug, R.; Krige, J. E. J.; Lignier, Delphine; Lindemann, Jessica; López-López, Víctor; Lucidi, Valério; Mabrut, Jean‐Yves; Månsson, Christopher; Mieog, Sven J. D.; Mirza, Darius F.; Oldhafer, Karl J.; Omoshoro-Jones, J.; Ortega, Nuria; Otto, W.; Panaro, Fabrizio; Pando, Elizabeth; Paterna-López, Sandra; Pekmezci, Salih; Pesce, Antonio; Porte, Robert J.; Poves, Ignasi; Prieto, Mikel; Primavesi, Florian; Puleo, Stefano; Recordare, Alfonso; Rizell, Magnus; Roberts, Keith; Robles, R; Sanchiz-Cardenas, E.; Sandström, Per; Sarıbeyoğlu, Kaya; Schauer, Matthias; Schreuder, Michiel F.; Siriwardena, Ajith K.; Smith, Martin D.; Silva, D. Sousa; Sparrelid, Ernesto; Stättner, Stefan; Stavrou, Gregor A.; Straka, Matús; Strömberg, C.; Sutcliffe, Robert P.; Szíjártó, Attila; Taflin, Helena; Trotovšek, Blaž; Gulik, TM van; Wallach, Nadav; Zieniewicz, Krzysztof

doi:10.1016/j.hpb.2019.04.003

Cited by 36 publications

(20 citation statements)

References 30 publications

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“…Furthermore, the need for a second procedure, that is, failure of the first repair, appeared to be higher after immediate and early repair than after late repair: 56.7% vs. 40.7% vs. 6.8%, respectively [111,233]. However, the E-AHPBA multicenter study showed, after multivariate regression analyses, that the timing of biliary reconstruction with hepaticojejunostomy does not have any impact on severe postoperative complications, the need for reintervention, or liver-related mortality, leaving advisable the choice of an individualized treatment strategy after iatrogenic BDI [234].…”

Section: Management Of Major Bdismentioning

confidence: 98%

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

et al. 2021

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Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

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Section: Management Of Major Bdismentioning

confidence: 98%

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

et al. 2021

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“…In addition, the research studies needed adequate planning, funding, and resources to be successful in such situations. This was seen to be a significant limitation, especially in LMICs [ 48 , 60 , 61 , 68 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

Catalysing global surgery: a meta-research study on factors affecting surgical research collaborations with Africa

Kirengo,

Dossajee,

Onyango

et al. 2024

Syst Rev

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Introduction In December 2019, the COVID-19 pandemic highlighted the urgent need for rapid collaboration, research, and interventions. International research collaborations foster more significant responses to rapid global changes by enabling international, multicentre research, decreasing biases, and increasing study validity while reducing overall research time and costs. However, there has been low uptake of collaborative research by African institutions and individuals. Aim To systematically review facilitating factors and challenges to collaborative surgical research studies conducted in Africa. Methodology A meta-research review using PubMed®/MEDLINE and Embase on surgical collaboration in Africa from 1st of January 2011 to 31st of September 2021 in accordance to PRISMA guidelines. Surgical studies by collaborative groups involving African authors and sites were included (55 papers). Data on the study period, geographical regions, and research scope, facilitating factors, and challenges were extracted from the studies retrieved from the search. Results Most of the collaborations in Africa occurred with European institutions (76%). Of the 54 African countries, 63% (34/54) participated in surgical collaborations. The highest collaboration frequency occurred in South Africa (11%) and Nigeria (8%). However, most publications originated from Eastern Africa (43%). Leveraging synergies between high- and low- to middle-income countries (LMICs), well-defined structures, and secure data platforms facilitated collaboration. However, the underrepresentation of collaborators from LMICs was a significant challenge. Conclusion Available literature provides critical insights into the facilitating factors and challenges of research collaboration with Africa. However, there is a need for a detailed prospective study to explore the themes highlighted further. Systematic review registration PROSPERO 2022 CRD42022352115.

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“…Three different classifications were used to characterize the type of major BDI: The Strasberg classification, the Bismuth classification, and the Stewart Way System. Fifteen studies, accounting for 49% ( n = 2440)[ 26 , 33 , 34 , 36 - 43 , 45 - 47 , 49 , 50 ] of BDIs, used the Strasberg classification system, three studies, including 8% ( n = 395)[ 43 , 47 , 51 ] of BDIs, used the Bismuth classification, and one study, reporting 6% ( n = 307)[ 18 ] of BDIs, used the Stewart Way System (Table 2 ) . Five studies, including 36% ( n = 17924)[ 25 , 27 , 28 , 35 , 49 ] of patients, did not identify which classification system was used.…”

Section: Resultsmentioning

confidence: 99%

“…Of note, one study including 12 patients used both the Bismuth and the Strasberg classification[ 39 ]. Concomitant vascular injury was reported in 4% ( n = 222)[ 28 , 33 , 34 , 36 , 37 , 43 - 45 , 47 ] of included patients.…”

Section: Resultsmentioning

confidence: 99%

“…In an attempt to standardize the population according to timing of BDI repair, a cut off of 14 d was proposed (Figure 4B ). This subgroup analysis revealed increased complications for a BDI repair within 14 d ( n = 1757)[ 2 , 11 , 15 , 16 , 20 , 27 , 29 , 30 , 37 , 38 , 42 , 43 , 45 - 49 ] when compared to surgical repair after this interval ( n = 2031)[ 18 , 20 , 25 - 28 , 33 , 40 , 42 , 43 , 47 , 49 , 51 ]. Nevertheless, this difference did not reach statistical significance, implicating that outcome is not dependent on timing of repair only.…”

Section: Resultsmentioning

confidence: 99%

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Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review

Kambakamba¹,

Cremen²,

Möckli³

et al. 2022

WJH

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BACKGROUND The surgical management of bile duct injuries (BDIs) after laparoscopic cholecystectomy (LC) is challenging and the optimal timing of surgery remains unclear. The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature. AIM To assess timing of surgical repair of BDI and postoperative complications. METHODS The MEDLINE, EMBASE, and The Cochrane Library databases were systematically screened up to August 2021. Risk of bias was assessed via the Newcastle Ottawa scale. The primary outcomes of this review included the timing of BDI repair and postoperative complications. RESULTS A total of 439 abstracts were screened, and 24 studies were included with 15609 patients included in this review. Of the 5229 BDIs reported, 4934 (94%) were classified as major injury. Timing of bile duct repair was immediate (14%, n = 705), early (28%, n = 1367), delayed (28%, n = 1367), or late (26%, n = 1286). Standardization of definition for timing of repair was remarkably poor among studies. Definitions for immediate repair ranged from < 24 h to 6 wk after LC while early repair ranged from < 24 h to 12 wk. Likewise, delayed (> 24 h to > 12 wk after LC) and late repair (> 6 wk after LC) showed a broad overlap. CONCLUSION The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC. This finding indicates an urgent need for a standardized reporting system of BDI repair.

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Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Cited by 36 publications

References 30 publications

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Catalysing global surgery: a meta-research study on factors affecting surgical research collaborations with Africa

Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review

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