Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation

Tanaka, Yujiro; Tainaka, Takahisa; Hinoki, Akinari; Shirota, Chiyoe; Sumida, Wataru; Yokota, Kazuki; Oshima, Koichiro; Makita, Satoshi; Amano, Hodaka; Takimoto, Aitaro; Kano, Yoko; Uchida, Hiroo

doi:10.1007/s00383-020-04791-0

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…No association was found between APHD and patient demographics, and APHD had no impact on PF or postoperative bile duct dilatation occurrence; however, BL occurred significantly more frequently in patients with APHD ( p < .05). It is generally accepted that smaller hilar bile duct diameter at the anastomotic site increase suture failure 26,27 . However, in this study, the APHD was formed to a single large hilar bile duct opening, and indeed the anastomotic site was large.…”

Section: Discussionmentioning

confidence: 61%

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Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Takada,

Uchida,

Hinoki

et al. 2023

J Hepato Biliary Pancreat

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PurposePreoperative comprehension of the anatomical variations of the hepatic artery and bile duct is essential for safe laparoscopic surgery for pancreaticobiliary maljunction (PBM). This study aimed to investigate the impact of anatomical variations of the hepatic artery and bile duct on surgical technique and postoperative complications.MethodsWe conducted a retrospective review of patients with PBM who underwent laparoscopic surgery at our institution between January 2014 and December 2022 to investigate anatomical variations in the hepatic artery and bile duct, surgical technique, and postoperative complications.ResultsWe included 112 patients with PBM, with a median age of 4 years (interquartile range, 0–55). Overall, 29 of 112 patients had an aberrant right hepatic artery (ARHA) running ventral to the common hepatic duct (CHD), and they underwent hepaticojejunostomy on the ventral side of the ARHA. Additionally, eight of 112 patients had an aberrant posterior hepatic duct (APHD), which was joined to the CHD in all but one case. The presence of APHD was associated with postoperative bile leak occurrence.ConclusionPerforming hepaticojejunostomy ventral to the ARHA is important to prevent complications. Furthermore, APHD may be a risk factor for postoperative bile leak and requires careful bile duct plasty.

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Section: Discussionmentioning

confidence: 61%

“…It is generally accepted that smaller hilar bile duct diameter at the anastomotic site increase suture failure. 26,27 However, in this study, the APHD was formed to a single large hilar bile duct opening, and indeed the anastomotic site was large. Therefore, the diameter at the anastomotic site did not appear to be associated with BL.…”

Section: Discussionmentioning

confidence: 64%

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Takada,

Uchida,

Hinoki

et al. 2023

J Hepato Biliary Pancreat

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“…In minimally invasive surgery for choledochal cysts in children, major complication rates of 5.3%–9.4% have been reported; bile leakage is reported to account for 1.9%–6.7% of these complications 1,2 . The difficulty of laparoscopic hepaticojejunostomy seems to be a bottleneck for this surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

“…In minimally invasive surgery for choledochal cysts in children, major complication rates of 5.3%-9.4% have been reported; bile leakage is reported to account for 1.9%-6.7% of these complications. 1,2 The difficulty of laparoscopic hepaticojejunostomy seems to be a bottleneck for this surgical procedure. Therefore, pediatric surgeons have to endeavor for acquisition of these skills for performing surgical procedures in choledochal cyst treatment.…”

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confidence: 99%

How we acquire suturing skills for laparoscopic hepaticojejunostomy

Murakami

Yamada

Onishi

et al. 2022

Asian J Endoscop Surgery

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Laparoscopic choledochal cyst excision and hepaticojejunostomy is a representative surgical procedure requiring laparoscopic suturing including needle driving and knot tying. Laparoscopic needle driving and knot tying is a highly technically demanding skill, especially in small infants and children. We developed a laparoscopic hepaticojejunostomy simulator for training. This simulator was developed for a 1-year-old infant body size based on computed tomography data and reproduced a pneumoperitoneum condition based on 3D scanner data of the clinical situation. Surgeon in training (SITs) of our institution have to acquire practice of laparoscopic hepaticojejunostomy using a simulator before performing clinical cases. Thirteen cases of choledochal cyst have been managed at our institution since the introduction of practice using this simulator in 2016. Six SITs performed 13 cases of laparoscopic choledochal cyst excision and hepaticojejunostomy. There

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Risk factors for the development of biliary tract infection after choledochal-malformation surgery

Cheng

Peng

Huo

et al. 2023

Asian Journal of Surgery

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Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation

Cited by 7 publications

References 18 publications

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

How we acquire suturing skills for laparoscopic hepaticojejunostomy

Risk factors for the development of biliary tract infection after choledochal-malformation surgery

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