The effect of concomitant vascular disruption in patients with iatrogenic biliary injuries

Bilge, Orhan; Bozkiran, Suheyla; Özden, İlgin; Tekant, Yaman; Alper, Aydın; Emre, Ali; Arıoğul, Orhan

doi:10.1007/s00423-003-0382-6

Cited by 18 publications

(14 citation statements)

References 15 publications

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“…Nevertheless, it is a technically demanding operation, which can ultimately lead to secondary biliary cirrhosis, especially if it fails in the first attempt (Mirza et al 1997;Nordin et al 2002;Fernandez et al 2004). One possible cause of reconstruction failure may be concomitant vascular injury, which is clinically silent in the majority of the patients (Bilge et al 2003). Although some reports accept concomitant vascular injury as a significant prognostic indicator, autopsy findings and anatomical studies do not support this idea.…”

Section: Discussionmentioning

confidence: 53%

“…The hepatic vasculature and the biliary tree may be injured during cholecystectomy (Lillemoe et al 1997;Nishio et al 1999;Erkan et al 2001;Koffron et al 2001;Buell et al 2002;Bilge et al 2003). Although bile duct injury is more common, detailed studies show that "silent" concomitant arterial injury may be detected in patients with bile duct injury (Erkan et al 2001;Koffron et al 2001;Nordin et al 2001).…”

Section: Discussionmentioning

confidence: 99%

“…Although some reports accept concomitant vascular injury as a significant prognostic indicator, autopsy findings and anatomical studies do not support this idea. The authors do not recommend routine angiography since an association between vascular injuries and clinical outcome has not been shown (Bilge et al 2003).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

Öncel

Özden

Bilge

et al. 2006

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

Öncel

Özden

Bilge

et al. 2006

Tohoku J. Exp. Med.

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“…Despite this fact, a correlation between right hepatic artery injury and success of biliary reconstruction has not been demonstrated (65). Furthermore, right hepatic artery repair is a demanding procedure with low success rates (66).…”

Section: E) How Is Right Hepatic Artery Injury Handled?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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“…It is possible then that vascular injuries have also been increased with laparoscopy. This is in fact reflected in the recent literature, with relevant reports evolving from case reports and small retrospective series [6,7,8,9,10,11] to larger and prospective ones [3,12,13,14,15,16]. The aim of this review article is to address the issue of concomitant vascular injuries with emphasis to its clinical relevance and impact on mortality and morbidity, with special attention to biliary complications.…”

Section: Introductionmentioning

confidence: 99%

Vascular Injuries in Laparoscopic Cholecystectomy: An Underestimated Problem

Tzovaras

Dervenis²

2006

Dig Surg

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Background: Bile duct injury is a severe complication of laparoscopic cholecystectomy and many reports focus on this topic, especially regarding the long-term success of repair of these injuries. There is some concern, however, as to whether concomitant vascular injuries can jeopardize reconstruction of a bile duct injury following laparoscopic cholecystectomy. Methods: A review of the current literature on the clinical significance and management of a concomitant vascular injury to the outcome of reconstruction of bile duct injuries following laparoscopic cholecystectomy. Relevant articles were extracted through PubMed, with secondary references obtained from key articles. Results: Although the relevant literature is generally poor, there is a trend of appearance of relatively large series on the topic over the last five years, as opposed to case reports or small series during the previous decade. Conclusion: The disruption of the hepatic arterial flow during laparoscopic cholecystectomy is usually well tolerated in an otherwise healthy patient. There is strong evidence that concomitant vascular injuries do not have any impact on mortality after biliary reconstruction. There is also evidence that does increase overall morbidity, but when it comes specifically to long-term anastomotic stricture formation, there is no strong evidence to support a negative impact of a concomitant vascular injury; this is especially true for centers/surgeons with HPB interest.

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The effect of concomitant vascular disruption in patients with iatrogenic biliary injuries

Abstract: The frequency of high-level biliary injury and morbidity were significantly higher in the BVI group. However, concomitant vascular injury had no significant effect on mortality and medium-term outcome of biliary reconstruction. Thus, routine preoperative angiography is not recommended.

Cited by 18 publications

References 15 publications

Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

Bile Duct Injury during Cholecystectomy Requiring Delayed Liver Transplantation: A Case Report and Literature Review

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

Vascular Injuries in Laparoscopic Cholecystectomy: An Underestimated Problem

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