Biliary peritonitis for duct of Luschka bile leak after laparoscopic cholecystectomy performed with a 10-mm harmonic scalpel

Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the biliopancreatic limb. We present a patient with signs and symptoms of acute cholecystitis. Laparoscopic cholecystectomy was complicated by postoperative bile leak. EDGE procedure was performed to access the remnant stomach and endoscopic evaluation revealed a perforated ulcer in the posterior duodenal bulb. Although unusual, in patients with bariatric surgery and upper abdominal pain, differential diagnosis including perforated ulcer of the biliopancreatic limb must be considered and early surgical exploration is essential.

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Comparative study between the conventional laparoscopic cholecystectomy and clipless cholecystectomy using a harmonic scalpel

Menoufia Medical Journal ◽

10.4103/1110-2098.155942 ◽

2015 ◽

Vol 28 (1) ◽

pp. 54

Author(s):

RedaMohamed Eltiras ◽

SaidIbrahim El Mallah ◽

Hatem Soltan ◽

NehadAbdo Zaid ◽

MoharamAbd Elsamie

Keyword(s):

Laparoscopic Cholecystectomy ◽

Comparative Study ◽

Harmonic Scalpel ◽

Conventional Laparoscopic Cholecystectomy ◽

Conventional Laparoscopic

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Intraoperative Treatment of Duct of Luschka during Laparoscopic Cholecystectomy: A Case Report and Revision of Literature

Case Reports in Surgery ◽

10.1155/2018/9813489 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Luigi Masoni ◽

Leandro Landi ◽

Riccardo Maglio

Keyword(s):

Case Report ◽

Bile Leak ◽

Bile Leakage ◽

Medical Systems ◽

Invasive Treatment ◽

Endoscopic Clip ◽

First Case ◽

Duct Of Luschka ◽

Clinically Significant

Background. Bile leakage still remains a serious complication during cholecystectomies. In limited cases, this complication may occur from injury of the so-called ducts of Luschka. These rare ducts are usually discovered intraoperatively, and their presence poses the risk of bile injury and clinically significant bile leak. Presentation Case. We present a unique case of a 59-year-old male patient with acute cholecystitis. After removal of the gallbladder, thorough inspection of the hepatic bed was made and a little bile leak was identified from a duct of Luschka 1 cm away from the gallbladder hilum. We report on the use of endoscopic QuickClip Pro® clips (Olympus Medical Systems Corp., Tokyo, Japan) to avoid further more invasive treatment. Discussion. Endoscopic retrograde cholangiopancreatography with sphincterotomy played a crucial role for diagnosis and treatment of bile leaks with success rate near 94%. Many authors have argued the role of relaparoscopy, Diagnosis may be intraoperatively but this option does not seem to occur very often; in fact, there is a lack of data in literature. Conclusion. This is the first case report of bile leak from duct of Luschka treated during the cholecystectomies with endoscopic clip.

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Retroperitoneal bile leak after laparoscopic cholecystectomy

BMJ Case Reports ◽

10.1136/bcr-2017-222750 ◽

2018 ◽

pp. bcr-2017-222750

Author(s):

Dee Zhen LIM ◽

Enoch Wong ◽

Sayed Hassen ◽

Yahya AL-Habbal

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Leak

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CASE REPORT: Radiological and endoscopic management of bile leak following laparoscopic cholecystectomy

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.1997.tb00342.x ◽

1997 ◽

Vol 12 (1) ◽

pp. 34-38 ◽

Cited By ~ 4

Author(s):

BASSAM M SAMMAK ◽

BUSHRA A YOUSEF ◽

MOHAMED H GALI ◽

MOHAMED A AL KARAWI ◽

ABDULRAHMAN E MOHAMED

Keyword(s):

Laparoscopic Cholecystectomy ◽

Case Report ◽

Bile Leak ◽

Endoscopic Management

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Endoscopic management of post laparoscopic cholecystectomy bile leak in a child

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(00)70464-0 ◽

2000 ◽

Vol 51 (4) ◽

pp. 506-507 ◽

Cited By ~ 6

Author(s):

Hari Prasad ◽

Ujjal Poddar ◽

Babu R. Thapa ◽

Deepak K. Bhasin ◽

Katragadda L.N. Rao ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Leak ◽

Endoscopic Management

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Bile Duct Injuries during Laparoscopic Cholecystectomy: Management and Outcome

The American Surgeon ◽

10.1177/000313480507101216 ◽

2005 ◽

Vol 71 (12) ◽

pp. 1060-1065 ◽

Cited By ~ 1

Author(s):

Kostas Tsalis ◽

Emmanouil Zacharakis ◽

Konstantinos Vasiliadis ◽

Stavros Kalfadis ◽

Orestis Vergos ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Definitive Treatment ◽

Biliary Disease ◽

Adequate Treatment ◽

Bile Duct Injuries ◽

Duct Ligation ◽

Duct Of Luschka ◽

Minor Injuries

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.

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