Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy

2002 ◽  
Vol 16 (7) ◽  
pp. 1098-1104 ◽  
Author(s):  
K. Ludwig ◽  
J. Bernhardt ◽  
H. Steffen ◽  
D. Lorenz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Intraoperative Cholangiography ◽  
Bile Duct Injuries

Does A Surgeon as First Assistant Reduce the Incidence of Common Bile Duct Injuries during Laparoscopic Cholecystectomy?

2010 ◽  
Vol 76 (3) ◽  
pp. 287-291
Author(s):  
Matt B. Martin ◽  
Kristen R. Earle
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
General Surgery ◽  
Retrospective Review ◽  
Intraoperative Cholangiography ◽  
Surgical Endoscopy ◽  
Bile Duct Injuries ◽  
Surgery Group

This retrospective review supports the hypothesis that a surgeon acting as first assistant during laparoscopic cholecystectomy will reduce the incidence of significant common bile duct (CBD) injuries (BDIs). Central Carolina Surgery, P.A., is a single-specialty general surgery group of 19 surgeons that have performed 8767 laparoscopic cholecystectomies from October 1999 to December 2007. In those cases, 89 per cent of the cases had surgeons as first assistants and 66 per cent of the cases were performed with intraoperative cholangiography. Five cases of BDI occurred during this period for an incidence of 0.0570 per cent. Only three of these injuries required bilioenteric anastomotic reconstruction. When this same group of surgeons learned to perform laparoscopic cholecystectomy in 1990, their published series (Surgical Endoscopy: [1993] 7:300 to 303] of 762 cases had 98 per cent of cases performed with a surgeon as first assistant and no CBD injuries. Only 27 per cent of those 762 cases had intraoperative cholangiograms. This single-practice general surgery experience supports the use of a surgeon as first assistant to lower the incidence of CBD injures.

Treatment of Common Bile Duct Injuries during Laparoscopic Cholecystectomy: Endoscopic and Surgical Management

2001 ◽  
Vol 25 (10) ◽  
pp. 1346-1351 ◽  
Author(s):  
Attila Csendes ◽  
Claudio Navarrete ◽  
Patricio Burdiles ◽  
Julio Yarmuch
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Surgical Management ◽  
Bile Duct Injuries

Common bile duct injuries during laparoscopic cholecystectomy that result in litigation

1998 ◽  
Vol 12 (4) ◽  
pp. 310-314 ◽  
Author(s):  
B. J. Carroll ◽  
M. Birth ◽  
E. H. Phillips
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Duct Injuries

scholarly journals Routine intraoperative cholangiography during laparoscopic cholecystectomy: application of the 2016 WSES guidelines for predicting choledocholithiasis

2021 ◽  
Author(s):  
Hui-Ying Lai ◽  
Kuei-Yen Tsai ◽  
Hsin-An Chen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Risk Groups ◽  
Intraoperative Cholangiography ◽  
Uneventful Recovery ◽  
Gallstone Pancreatitis ◽  
Cbd Stones ◽  
Study Results ◽  
Wses Guidelines

Abstract Background Routine use of intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) for detecting common bile duct stones remains controversial. The 2016 World Society of Emergency Surgery (WSES) guidelines on acute calculous cholecystitis proposed a risk stratification for choledocholithiasis. Our present study aimed to (1) examine the findings of common bile duct (CBD) stones in patients underwent LC with routine use of IOC, and (2) validate the 2016 WSES risk classes for predicting choledocholithiasis. Methods All patients had LC with IOC routinely performed from November 2012 to December 2017 were reviewed retrospectively. Patients were classified into high-, intermediate-, and low-risk groups based on the 2016 WSES risk classes with modification. Results A total of 990 patients with LC and routine IOC were enrolled. CBD stones were detected in 197 (19.9%) patients. The rate of CBD stone detected in low-, intermediate-, high-risk groups were 0%, 14.2%, and 89.6%, respectively. Predictors as following: evidence of CBD stones on abdominal ultrasound or computed tomography, CBD diameter > 6 mm, total bilirubin > 4 mg/dL, bilirubin level = 1.8–4 mg/dL, abnormal liver biochemical test result other than bilirubin, presence of clinical gallstone pancreatitis had statistical significance between patients with and without CBD stones. Major bile duct injury was found in 4 patients (0.4%). All 4 patients had uneventful recovery after repair surgery. Conclusions Based on our study results, the 2016 WSES risk classes for choledocholithiasis could be an effective approach for predicting the risk of choledocholithiasis. Considering its advantages for detecting CBD stones and biliary injuries, the routine use of IOC is still suggested.

scholarly journals Early Surgical Repair of Bile Duct Injuries following Laparoscopic Cholecystectomy: The Sooner the Better

2019 ◽  
Vol 05 (04) ◽  
pp. e154-e158 ◽  
Author(s):  
Muharrem Battal ◽  
Pinar Yazici ◽  
Ozgur Bostanci ◽  
Oguzhan Karatepe
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Surgical Procedures ◽  
Surgical Repair ◽  
Primary Repair ◽  
Type D ◽  
Bile Duct Injuries ◽  
Time To Diagnosis ◽  
Type C

Abstract Background We aimed to investigate the outcomes of the immediate surgical repair of bile duct injuries (BDIs) following laparoscopic cholecystectomy. Materials and Methods Between January 2012 and May 2017, patients, who underwent immediate surgical repair (within 72 hours) for postcholecystectomy BDI, by the same surgical team expert in hepatobiliary surgery, were enrolled into the study. Data collection included demographics, type of BDI according to the Strasberg classification, time to diagnosis, surgical procedures, and outcome. Results There were 13 patients with a mean age of 43 ± 12 years. Classification of BDIs were as follows: type E in six patients (46%), type D in three patients (23%), type C in two (15%), and types B and A in one patient each (7.6%). Mean time to diagnosis was 22 ± 15 hours. Surgical procedures included Roux-en-Y hepaticojejunostomy for all six patients with type-E injury, primary repair of common bile duct for three patients with type-D injury, and primary suturing of the fistula orifice was performed in two cases with type-C injury. Other two patients with type-B and -A injury underwent removal of clips which were placed on common bile duct during index operation and replacing of clips on cystic duct where stump bile leakage was observed probably due to dislodging of clips, respectively. Mean hospital stay was 6.6 ± 3 days. Morbidity with a rate of 30% (n = 4) was observed during a median follow-up period of 35 months (range: 6–56 months). Mortality was nil. Conclusion Immediate surgical repair of postcholecystectomy BDIs in selected patients leads to promising outcome.

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