Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injury during laparoscopic cholecystectomy

1996 ◽  
Vol 83 (7) ◽  
pp. 1014-1014 ◽  
Author(s):  
L. Fligelstone ◽  
N. Wanendeya ◽  
B. Palmer ◽  
E. Kullman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Bile Ducts ◽  
Intraoperative Cholangiography

Impact of routine intraoperative cholangiography during laparoscopic cholecystectomy on bile duct injury

2014 ◽  
Vol 101 (6) ◽  
pp. 677-684 ◽  
Author(s):  
F. A. Alvarez ◽  
M. de Santibañes ◽  
M. Palavecino ◽  
R. Sánchez Clariá ◽  
O. Mazza ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Intraoperative Cholangiography

scholarly journals Tulžies latakų sužalojimai atliekant laparoskopinę cholecistektomiją

2007 ◽  
Vol 5 (2) ◽  
pp. 0-0
Author(s):  
Donatas Venskutonis ◽  
Linas Urbanavičius ◽  
Juozas Juočas ◽  
Saulius Bradulskis ◽  
Virmantas Daubaras ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
General Surgery ◽  
Bile Ducts ◽  
Diffuse Peritonitis ◽  
Clinical Hospital ◽  
Bile Duct Injuries ◽  
Extrahepatic Bile Ducts ◽  
Iatrogenic Bile Duct Injury

Donatas Venskutonis, Linas Urbanavičius, Juozas Juočas, Saulius Bradulskis, Virmantas Daubaras, Juozas KutkevičiusKauno medicinos universiteto Bendrosios chirurgijos klinika,VšĮ Kauno II klinikinė ligoninė, Josvainių g. 2, LT-47133 KaunasEl paštas: [email protected] Įvadas / tikslas Manoma, kad atliekant laparoskopinę cholecistektomiją ekstrahepatiniai tulžies latakai sužalojami dažniau nei atvirąją. Įvykus tulžies latakų sužalojimui, svarbu jį kuo skubiau diagnozuoti ir tinkamai gydyti. Siūlomos įvairios sužalojimų prevencijos priemonės. Šio darbo tikslas – išanalizuoti KMU Bendrosios chirurgijos klinikoje 1994–2006 metais laparoskopinės cholecistektomijos metu įvykusių ekstrahepatinių tulžies latakų jatrogeninių sužalojimų dažnį, priežastis, gydymo metodus, padarinius ir prevencijos priemones, apžvelgti literatūros duomenis. Ligoniai ir metodai Analizavome 1994–2006 m. KMU Bendrosios chirurgijos klinikoje (VšĮ II KKL) dėl tulžies latakų jatrogeninių sužalojimų, įvykusių laparoskopinės cholecistektomijos metu, gydytų pacientų ligos istorijas. Rezultatai Per minėtą laikotarpį atliktos 5396 laparoskopinės cholecistektomijos: 1681 (31,2%) pacientui – dėl ūminio ir 3715 (68,8%) – dėl lėtinio cholecistito. Po operacijos 7 ligoniai mirė. Vienas ligonis mirė nuo bendrojo tulžies latako sužalojimo ir pankreatito. Kitos mirties priežastys: trims ligoniams buvo plaučių arterijos embolija, vienam – dvylikapirštės žarnos perforacija ir peritonitas, dviem – gangreninis cholecistitas ir lokalus peritonitas. Bendras mirštamumas 0,13%. Ekstrahepatiniai tulžies latakai sužaloti 10 ligonių (0,19%). Vienas ligonis gydytas nuo tulžies latakų sužalojimo kitoje ligoninėje. Išvados Apibendrinus rezultatus galima tvirtinti, kad tulžies latakų sužalojimo ir mirties atvejai operuojant laparoskopiškai yra reti, o laparoskopinė cholecistektomija mūsų klinikoje – saugi operacija. Atvira cholecistektomija pranašesnė tik sunkiais, komplikuotais atvejais (neaiški anatomija, tulžies pūslės-žarnyno fistulės) ir nesant galimybės išgydyti tulžies latakų akmenligės endoskopiškai. Pagrindiniai žodžiai: cholecistitas, laparoskopinė cholecistektomija, ekstrahepatiniai tulžies latakai, sužalojimai Bile duct injuries during laparoscopic cholecystectomy donatas venskutonis, linas urbanavičius, juozas juočas, saulius bradulskis, virmantas daubaras, juozas kutkevičiusKaunas University of Medicine Clinic of General Surgery, Kaunas 2nd Clinical Hospital,Josvainių str. 2, LT-47133, Kaunas, LithuaniaE-mail: [email protected] Background / objective Laparoscopic cholecystectomy is associated with a higher risk of extrahepatic bile duct injuries. Timely diagnosis and proper management of bile duct injury are very important. Various preventive measures are widely discussed. Our aim was to analyze iatrogenic injuries of extrahepatic bile ducts sustained during laparoscopic cholecystectomy over the period 1994–2006 at the Clinic of General Surgery of Kaunas University of Medicine and to review the relevant pub-lished reports. Patients and methods Analysis of the case histories of patients treated for iatrogenic bile duct injuries sustained during laparoscopic cholecystectomy over the period 1994–2006 at the Clinic of General Surgery of Kaunas University of Medicine (2nd Clinical Hospital), Lithuania. Results During the period 1994–2006, 5396 patients underwent laparoscopic cholecystectomy for acute cholecystitis (n = 1681, 31.2%) and chronic gallstone disease (n = 3715, 68.8%). Seven patients died after surgery: one patient died of bile duct injury, 3 patients of pulmonary artery embolism; there were one case of duodenum perforation and diffuse peritonitis, one case of severe acute pancreatitis, and 2 cases of gangrenous cholecystitis with peritonitis. The overall mortality rate was 0.13%. Iatrogenic bile duct injury occurred in 10 cases (0.19%). One patient was referred from another hospital and was treated for a iatrogenic bile duct injury. Conclusions The incidence of bile duct injuries and the death rate were low. Laparoscopic cholecystectomy was performed with acceptable safety in our clinic. Conventional cholecystectomy was preferred to laparoscopic cholecystectomy in difficult, complicated cases (unclear anatomy, biliary enteric fistulas) and in cases of unsuccessful endoscopic treatment of choledocholithiasis and obstructive jaundice. Keywords: cholecystitis, laparoscopic cholecystectomy, extrahepatic bile ducts, injuries

scholarly journals Iatrogenic Bile Duct Injury Associated with Anomalies of the Right Hepatic Sectoral Ducts: A Misunderstood and Underappreciated Problem

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Nitin Babel ◽  
Sujit V. Sakpal ◽  
Prakash Paragi ◽  
Jason Wellen ◽  
Stephen Feldman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Open Cholecystectomy ◽  
Standard Of Care ◽  
Number Of Patients ◽  
The Right ◽  
Iatrogenic Bile Duct Injury

Although laparoscopic cholecystectomy (LC) has been widely accepted as the standard of care, it continues to have a higher complication rate than open cholecystectomy. Bile duct injury with LC has often been attributed to surgical inexperience, but it is also clear that aberrant bile ducts are present in a significant number of patients who sustain biliary injuries during these procedures. We present three cases of right sectoral hepatic duct injuries which occurred during LC and provide a discussion of the conditions which are likely to lead to these injuries, as part of a strategy to prevent them.

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