Bile duct injuries following laparoscopic cholecystectomy: A clinical study (original) (raw)
Related papers
2018
Background: Nowadays, cholecystectomy is the most prevalent elective abdominal surgery in the U.S., with over 750000 operations performed every year. However, laparoscopic cholecystectomy has been reported with 1% to 8% of major complications, including hemorrhage, wound infection, bile ducts and gallbladder damage. Methods: A total of 1970 medical records of patients undergone laparoscopically at Modarres Hospital between 2010 and 2017 were studied in this research. Of them 1185 were female (60.15%) and 785(39.85%) male. A total of 1003(50.9%) patients were presented with cholecystitis, 955(48.5%) with symptomatic cholelithiasis, and 12(0.6%) with polyp. Results: Biliary tract injury was reported in 11 cases, complete cut off of Common Bile Duct (CBD) in 4(0.2%) cases (3 males and 1 female), partial CBD injuries in 3 cases (2 males and 1 female), complete closure of CBD in 1 female case, and partially closure of CBD by clips in 3(0.1%) cases (1 male and 2 female). Conclusion: The laparoscopic method seems to be the ideal method of cholecystectomy, not just because of its cosmetic reasons, also due to its less invasive procedure.
ANZ Journal of Surgery, 1999
The aim of this study is to analyze our experience with the management of bile duct injuries (BDIs) following laparoscopic cholecystectomy (LC). From 1996 to 2004, 21 patients with BDI after LC were treated in our department. The BDIs were graded according to the classification of Strasberg. Ten patients had minor BDI. Minor injuries were classified as A in six and D in four patients. In three patients, endoscopic retrograde cholangiopancreatography sphincterotomy and stent placement was adequate treatment. Six patients required laparotomy and bile duct ligation or suturing, and one patient underwent laparoscopy with additional ligation of a duct of Luschka. Eleven patients had major BDIs. These injuries were classified as E1 in two, E2 in three, E3 in four, and E4 in two patients. Among the patients with a major BDI, Roux-en-Y hepaticojejunostomy was performed. After a median follow-up of 69.45 months, no evidence of biliary disease has been detected among our patients. BDIs should be managed in a specialist unit where surgeons skilled to perform such repairs should undertake definitive treatment. Roux-en-Y hepaticojejunostomy is the procedure of choice in the management of major BDIs as it is accompanied by satisfactory results.
BILE DUCT INJURIES; FREQUENCY DURING CHOLECYSTECTOMY PROCEDURES EITHER OPEN OR LAPAROSCOPIC
Objective: To find out frequency of bile duct injuries during cholecystectomy procedures either open or laparoscopic. Study design: Prospective observational study. Place and duration of study: This study was conducted at Surgical department, Liaquat University Hospital Jamshoro and Dow International Hospital Karachi, from July 2012 to December 2013. Methodology: This study consisted of hundred patients. Patients were divided in two groups. Group A for open cholecystectomy (OC) comprising of 50 patients who underwent elective open cholecystectomy. Group B for Laparoscopic cholecystectomy (LC) comprising of 50 patients who underwent elective Laparoscopic cholecystectomy. Inclusion criteria were all patients diagnosed case of gallstones on the basis of ultrasound abdomen, any age and both gender. Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructive jaundice. Results: Out of 100 cases of gallstone were operated for either laparoscopic / open cholecystectmy. In open cholecystectomy group 20(40 % ) were male and 30(60 %) female. Ratio male: female ratio of 1:1.5. In laparoscopic cholecystectomy group 11(22 % ) were male and 39(78 %) female with male: female ratio of 1:3.5. There was wide variation of age ranging from a minimum of 10 year to 70 year in both group. The mean age was 41.28+12.30 years for OC group and 38.44+13.50 years for LC group (p 0.02). Common bile duct injury were occurred 2(4%) patients in laparoscopic cholecystectomy group while 3(6%) patients observed in open cholecystectomy group. Conclusions: We conclude that found bile duct injury 2(4%) patients in laparoscopic cholecystectomy group while 3(6%) patients observed in open cholecystectomy group. Key words: Laparoscopic cholecystectomy, Open cholecystectomy, Bile duct injury
Injuries to the Bile Duct Resulting From Laparoscopic Cholecystectomy
ANZ Journal of Surgery, 1993
Laparoscopic cholecystectomy has now become the treatment of choice for symptomatic gall stones. There does, however, appear to be an increased incidence of bile duct injuries. In this article, experience with eight patients who sustained a bile duct injury and were referred to the Hepatobiliary Selvice at Westmead Hospital, between 1990 and 1992, is reported.
Bile duct injury following laparoscopic cholecystectomy: referral pattern and management
British Journal of Surgery, 1997
Background Laparoscopic cholecystectomy is associated with a higher incidence of bile duct injury than open cholecystectomy. This study reviews the management of bile duct injury in a tertiary hepatobiliary unit. Methods From 1991 to 1995, 27 patients (18 women) of median age 49 (range 25-67) years were referred to this unit with bile duct injury following elective laparoscopic cholecystectomy. Laparoscopic cholecystectomy was described as 'uneventful' in 14 and 'difficult' in 13 patients; six injuries were recognized at operation. cholecystectomy, although initial symptoms were recorded a median of 3 (range 0-700) days after cholecystectomy. Fifteen patients underwent additional surgery before referral. Management before referral included surgical exploration (15 patients), endoscopic cholangiography (ERC) and stent insertion (three), external drainage of bile collections (five), and conservative management (five). Management after referral included surgical reconstruction (1 9 patients), laparotomy with drainage (one), percutaneous drainage (two), ERC and stent insertion (two), percutaneous cholangiography with dilatation and stent placement (three), and conservative management (two). One patient died and the median inpatient stay following referral was 14 (range 7-78) days. Ten of 15 patients who had surgery before referral required a further biliary reconstruction. After median follow-up of 30 (range 3-60) months, four of nine patients with complex high injuries continue to have episodes of cholangitis and one patient has developed secondary biliary cirrhosis. problem and results in significant postoperative morbidity. Most patients referred after attempted repair require further reconstructive surgery, and patients with complex high injuries have a risk of long-term morbidity. Results Patients were transferred a median of 26 (range 0-990) days after laparoscopic ' Conclusion Bile duct injury following laparoscopic cholecystectomy is a complex management
Surgical Endoscopy and Other Interventional Techniques, 2004
Background Bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC) still are reported with greater frequency than during open cholecystectomy (OC). Methods In 1999, a retrospective study evaluating the incidence of BDIs during LC in the area of Rome from 1994 to 1998 (group A) was performed. In addition, a prospective audit was started, ending in December 2001 (group B). Results In group A, 6,419 LCs were performed (222 were converted to OC; 3.4%). In group B, 7,299 LCs were performed (225 were converted to OC; 3.1%). Seventeen BDIs (0.26%) occurred in group A and 16 (0.22%) in group B. Overall, mortality and major morbidity rates were 12.1% and 30.3%, respectively, without significant differences between the two groups. Conclusions The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.