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

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

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.

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.

scholarly journals ERCP Following Laparoscopic Cholecystectomy: A Safe and Effective way to Manage CBD Stones and Complications

HPB Surgery ◽  
1995 ◽  
Vol 8 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Colleen M. Schmitt ◽  
John Baillie ◽  
Peter B. Cotton
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Biliary Tree ◽  
Bile Duct Stones ◽  
Operative Complication ◽  
Cbd Stones ◽  
Bile Duct Injuries

The efficacy of ERCP in detecting and treating post-laparoscopic cholecystectomy problems was examined in a series of consecutive patients undergoing directed examination of the biliary tree over a two-year period. Three major diagnostic groups were identified: leaks and bile duct injuries (n = 9), retained common bile duct stones (n = 18), and post-cholecystectomy pain (n = 13). These diagnostic groups differed in degree of abnormal bilirubin (p = .004) and time between surgery and ERCP (p = .0005). Diagnosis of a post-operative complication was successful in 92% of attempted cases. Therapy was successful in 92% of attempted cases. Three patients developed mild pancreatitis as a result of ERCP. This series underscores the efficacy of a multi-disciplinary approach to problems which occur after laparoscopic cholecystectomy.

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