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Management Of Major Biliary Complications After Laparoscopic Cholecystectomy

G. Branum, C. Schmitt, J. Baillie, P. Suhocki, M. Baker, A. Davidoff, S. Branch, R. Chari, G. Cucchiaro, E. Murray, T. Pappas, P. Cotton, W. Meyers
Published 1993 · Medicine

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OBJECTIVE A total of 50 major bile duct injuries after laparoscopic cholecystectomy were managed by the Duke University Hepatobiliary Service from 1990-1992. The management of these complex cases is reviewed. SUMMARY BACKGROUND DATA Laparoscopic cholecystectomy is the preferred method for removing the gallbladder. Bile duct injury is the most feared complication of the new procedure. METHODS Review of videotapes, pathology, and management of the original operations were reviewed retrospectively, and the injuries categorized. Major biliary injury was defined as a recognized disruption of any part of the major extrahepatic biliary system. Biliary leakage was defined as a clinically significant biliary fistula in the absence of major biliary injury, i.e., with an intact extrahepatic biliary system. RESULTS Thirty-eight injuries were major biliary ductal injuries and 12 patients had simple biliary leakage. Twenty-four patients had the classic type injury or some variant of the classic injury. A standard treatment approach was developed which consisted of ERCP for diagnosis, preoperative PTC with the placement of stents, CT drainage immediately after the PTC for drainage of biliary ascites, and usually Roux-en-Y hepaticojejunostomy with placement of O-rings for future biliary access if necessary. Major ductal injuries were high in the biliary system involving multiple ducts in 31 of the 38 patients. Re-operation was required in 5 of the 38 patients with particularly complex problems. CONCLUSIONS Successful management of bile duct injury after laparoscopic cholecystectomy requires careful understanding of the mechanisms, considerable preoperative assessment by experts, and a multidisciplinary approach.

This paper is referenced by
The Role of Endoscopic Procedures in the Management of Postcholecystectomy and Posttraumatic Biliary Leak
S. M. Bose (2001)
Injuries Presentations in Laparoscopic Versus Open Cholecystectomy
Mohamed S Abdel-Hamid (2015)
The Difficult Cholecystectomy: Problems During Dissection and Extraction
H. L. Laws (1998)
Bilomas developing after laparoscopic biliary surgery: percutaneous management with embolization of biliary leaks.
V. Oliva (1997)
Diagnostik und Therapie von Gallelecks nach laparoskopischer Cholezystektomie
P. Schrenk (2007)
Colangiografia intraoperatoria in corso di colecistectomia laparoscopica : selettiva o di routine?
F. Piacentini (2003)
Complications of Laparoscopy and Thoracoscopy
P. Paw (1994)
Current Status of Laparoscopic Therapy of Cholecystolithiasis and Common Bile Duct Stones
A. Shamiyeh (2005)
Aspectos demográficos en lesión de vía biliar en un periodo de 8 meses en colecistectomía laparoscópica en el Hospital Central Militar
Eric Contreras-Sibaja (2015)
Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines
Y. Yamashita (2007)
Management of Common Bile Duct Injuries
J. Haney (2007)
Devastating and fatal complications associated with combined vascular and bile duct injuries during cholecystectomy.
J. Buell (2002)
Management of major bile duct injury after laparoscopic cholecystectomy: a case report
A. Manouras (2009)
Diagnosis of right hepatic duct injury after cholecystectomy: the use of cholangiography through percutaneous drainage catheters.
I. Schipper (1996)
Cirugía laparoscópica biliar Laparoscopic biliary surgery
P. Martí-Cruchaga (2005)
Endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures
M. Farah (2008)
Tratamiento de pacientes con lesiones graves de la vía biliar
F. G. Rodríguez (2008)
Title Surgical treatment of patients with acute cholecystitis : Tokyoguidelines
W. A. (2007)
Recognition of laparoscopic bile duct injuries by intraoperative ultrasonography
M. Birth (2004)
Derivação hepaticojejunal sem sutura: uma alternativa para reconstituição da via biliar
L. A. Miranda (1998)
Tratamiento endoscópico de las estenosis biliares posquirúrgicas: Experiencia de 13 años
Manuel Gea González (2003)
An Old Treatment for a New Disease
Jack Pickleman (2016)
Colecistectomía abierta versus laparoscópica: experiencia en el Hospital San Juan de Dios
Juan José Zúñiga-Vargas (2002)
[Injuries of the extrahepatic bile ducts. Clinical aspects, diagnosis and therapy].
U. Sulkowski (1996)
Editorial: Laparoscopic cholecystectomy in routine practice: Duct injury as an index event
Thomas F. Gorey (1999)
Conservative approach in the treatment of the biliary tract's iatrogenic lesions.
G. Sportelli (2000)
Le risque de plaies biliaires au cours de la cholécystectomie par laparoscopie
G. Nuzzo (2004)
Biliary duct injury: partial segment IV resection for intrahepatic reconstruction of biliary lesions.
M. Mercado (1999)
Clinical features and mechanisms of major laparoscopic biliary injury.
A. Davidoff (1993)
Laparoscopic iatrogeny of the hepatic hilum as an indication for liver transplantation
J. A. Fernández (2004)
Acute cholecystitis: when is the best time for laparoscopic cholecystectomy?
N. Condilis (2008)
Hepatic resection for post-cholecystectomy bile duct injuries: a literature review.
S. Truant (2010)
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