scholarly journals Choledochoplasty by Vein Grafts in Iatrogenic Bile Duct Injuries

HPB Surgery ◽  
1992 ◽  
Vol 5 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Aws S. Salim
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Catheter ◽  
Tissue Loss ◽  
Stricture Formation ◽  
Vein Grafts ◽  
Bile Duct Injuries ◽  
Considerable Morbidity

The quality of immediate repair of common bile duct injuries with or without tissue loss occurring during elective cholecystectomy is crucial and maybe the sole factor behind future stricture formation with its considerable morbidity and mortality. Successful repair of iatrogenic common bile duct injuries has been achieved by immediate saphenous vein grafts in two patients with cystic duct avulsion, in one patient whose duct was split by a balloon catheter, and in one patient where a segment of the duct was resected. Follow-up for 5 years demonstrated that the grafting remained sound and produced no complications. Consequently, the immediate repair of iatrogenic bile duct injuries using vein grafts deserves consideration.

scholarly journals Surgical management and follow up of patients with bile duct injuries in tertiary health care institute

2021 ◽  
Vol 8 (3) ◽  
pp. 954
Author(s):  
Shahnawaz Akram ◽  
Sadaf Ali ◽  
Omer Javid Shah ◽  
Anzar Santosh
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Type D ◽  
Bile Duct Injuries ◽  
Definitive Repair ◽  
Type C ◽  
The Mean ◽  
Surgical Unit

Background: Bile duct injury is an iatrogenic catastrophe associated with significant mortality, morbidity, decrease quality of life and higher rates of subsequent litigation. We conducted a study to analyse the presentation and pattern of bile duct injury managed at our surgical unit. Operative details, type of surgery, complications associated with the repair and Follow up in terms of liver function tests.Methods: The study included evaluation of 56 patients who had suffered bile duct injuries and then were subsequently being managed surgically at our institute retrospectively from October-2009 to 2012 and prospectively onwards till October- 2014. The mean follow up period in case of our study was 26.8 months. The follow up LFTs were performed at regular intervals. MRCP was used as a gold standard investigation.Results: jaundice (64.2%) was the most common presentation. Injuries noted were, type E1 in 16 (28.5%),type E2 in 11(19.6%), type E3 in 1 (1.8%), type A in 2 (3.6%), type B in 3 (5.4%), type C in 5 (9%) and type D in 18 (32.1%) of patients. Roux-en-y Hepatico-jejunostomy was the common definitive repair performed (85.7%) with various modifications. The mean bilirubin levels and ALP levels showed a downward trend in follow up .5 patients were readmitted with features of cholangitis in which 2 patients were reoperated and 3 patients were managed conservatively, 2 patients died.Conclusions: The management of patients with BDI is a challenge for a surgeon and often requires the skills of experienced hepatobiliary surgeons at tertiary referral canters.  

Balloon Catheter Dilatation of Stenotic Common Bile Duct Anastomoses in the Pig

1987 ◽  
Vol 28 (1) ◽  
pp. 115-120
Author(s):  
U. Nilsson ◽  
L. Ekelund ◽  
L.-E. Hammarström ◽  
T. Holmin ◽  
N. Jonsson
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Thrombus Formation ◽  
Balloon Catheter ◽  
Percutaneous Transhepatic Cholangiography ◽  
Bile Duct Wall ◽  
Duct Wall ◽  
Catheter Dilatation

Fibrotic stenosing anastomoses of the common bile duct were surgically created in pigs in order to investigate the effects of percutaneous transhepatic balloon catheter dilatation. In a group of 6 animals, not treated with balloon dilatation, percutaneous transhepatic cholangiography and microscopic examination of the stricture were performed 5 to 25 weeks postoperatively. A persistent stenosis and slight to moderate fibrosis of the bile duct wall and peribiliary tissue were observed. In 5 animals the stenotic anastomosis was dilated.4 to 10 weeks postoperatively and this resulted in widening of the stricture and necrosis of the mucosa at the stricture site. Rupture of the fibrotic tissue in the bile duct wall and thrombus formation in the peribiliary veins also occurred in one of these 5 animals. Short-term follow-up in 3 animals 4 to 6 weeks after balloon dilatation showed almost complete fibrotic healing and partial re-stenosis of the anastomoses.

scholarly journals Management of Bile Duct Injury Following Cholecystectomy

2020 ◽  
Vol 18 (2) ◽  
pp. 214-218
Author(s):  
Bala Ram Malla ◽  
Nripesh Rajbhandari ◽  
Robin Man Karmacharya
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Open Cholecystectomy ◽  
Biliary Tree ◽  
Endoscopic Stenting ◽  
Bile Duct Injuries ◽  
Biliary Anastomosis ◽  
Classification Management

Background: Laparoscopic cholecystectomy is responsible for 80-85% of the bileduct injury, and twice as frequentcompared to open cholecystectomy.Injury affects the quality of life and overall survival of the patient. The management of these injuries is complex and challenging. There are few locally published reports regarding management of bile duct injury. The objective of this study is to evaluate the management of bile duct injury and its outcome Methods: This retrospective study includes patients bile duct injury following cholecystectomy who were managed at Dhulikhel Hospital, Nepal, during January 2014 to December 2016. The clinical features, type of injuries(Strasberg classification) management, outcome (as per McDonald and colleague grading system) and follow up were analyzed descriptively. Results: Out of 35 bile duct injuries,only 3 (8.57%)occurred following open cholecystectomy. Three (8.7%) cases of bile duct injury were diagnosed intraoperatively and had primary biliary anastomosis over T-tube. Five (14.28%) were diagnosed postoperatively and underwent Roux-en-y hepatojejunostomy 6 weeks after index surgery. And, 27(77.14%) with type A injuries were treated by endoscopic retrograde cholangio-pancreatography and stenting. After surgical repair, 1 (2.85%) had transient biliary leak. One patient had grade B outcome. During 18 months follow up, no stricture or cholangitis were observed. Conclusions: Bile duct injury with intact continuity of the duct can be successfully managed with endoscopic stenting of the biliary tree. Intraoperative diagnosis of bile duct injury and immediate surgical management has good outcome. Keywords: Bile duct injury; cholecystectomy; repair; strasberg classification

Quality-of-life assessment in the treatment of iatrogenic bile duct injuries: hepaticojejunostomy versus end-to-end biliary reconstructions

2012 ◽  
Vol 82 (12) ◽  
pp. 923-927 ◽  
Author(s):  
Beata Jabłońska ◽  
Marek Olakowski ◽  
Paweł Lampe ◽  
Zygmunt Górka ◽  
Łukasz Bułdak
Keyword(s):  
Quality Of Life ◽  
Bile Duct ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Bile Duct Injuries ◽  
End To End

scholarly journals Gallstone Ileus following Endoscopic Stone Extraction

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yoshiya Yamauchi ◽  
Noritaka Wakui ◽  
Yasutsugu Asai ◽  
Nobuhiro Dan ◽  
Yuki Takeda ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Gallstone Ileus ◽  
Balloon Catheter ◽  
Common Bile Duct Stones ◽  
Abdominal Distension ◽  
Abdominal Ultrasonography ◽  
Stent Occlusion ◽  
Plastic Stent ◽  
Rosai Hospital

An 85-year-old woman was an outpatient treated at Tokyo Rosai Hospital for cirrhosis caused by hepatitis B. She had previously been diagnosed as having common bile duct stones, for which she underwent endoscopic retrograde cholangiopancreatography (ERCP). However, as stone removal was unsuccessful, a plastic stent was placed after endoscopic sphincterotomy. In October 2012, the stent was replaced endoscopically because she developed cholangitis due to stent occlusion. Seven days later, we performed ERCP to treat recurring cholangitis. During the procedure, the stone was successfully removed by a balloon catheter when cleaning the common bile duct. The next day, the patient developed abdominal pain, abdominal distension, and nausea and was diagnosed as having gallstone ileus based on abdominal computed tomography (CT) and abdominal ultrasonography findings of an incarcerated stone in the terminal ileum. Although colonoscopy was performed after inserting an ileus tube, no stone was visible. Subsequent CT imaging verified the disappearance of the incarcerated stone from the ileum, suggesting that the stone had been evacuated naturally via the transanal route. Although it is extremely rare for gallstone ileus to develop as a complication of ERCP, physicians should be aware of gallstone ileus and follow patients carefully, especially after removing huge stones.

Long-Term Follow-Up After Endoscopic Treatments for Common Bile Duct Stones

2009 ◽  
Vol 69 (5) ◽  
pp. AB152
Author(s):  
Shinpei Doi ◽  
Ichiro Yasuda ◽  
Masanori Nakashima ◽  
Takuji Iwashita ◽  
Keisuke Iwata ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Long Term Follow Up

scholarly journals Abordaje laparoscópico sistemático de la coledocolitiasis

2021 ◽  
Vol 113 (1) ◽  
pp. 62-72
Author(s):  
Carlos M. Canullán ◽  
◽  
Enrique J. Petracchi ◽  
Nicolás Baglietto ◽  
Hugo I. Zandalazini ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Preoperative Diagnosis ◽  
Length Of Hospital Stay ◽  
Common Bile Duct Stones ◽  
Single Stage ◽  
Bile Duct Stones ◽  
Bile Duct Injuries ◽  
Transcystic Approach

Background: The prevalence of common bile duct stones associated with cholelithiasis increases with age and is about 15 % in the 8th decade of life but its management is still controversial. Some surgeons prefer the single-stage approach with laparoscopy while others suggest the two-stage management with preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Objective: The aim of the present study was to evaluate the efficacy of feasibility of single-stage laparoscopic surgery in patients with cholelithiasis and choledocholithiasis. Material and methods: We conducted a retrospective study with prospectively collected data between July 2008 and July 2018. Results: Of 2447 laparoscopic cholecystectomies performed during the study period, 416 presented common bile duct stones. The global success of the transcystic approach to clear common bile duct stones was 81.2%, 70.4% in the cases with preoperative diagnosis of choledocholithiasis and 92.9% for other diagnoses. The rate of complications was 4% without deaths or bile duct injuries. Conclusion: Single-stage laparoscopic surgery is an efficient and safe approach based on the high global success of transcystic exploration. The preoperative diagnosis of choledocholithiasis reduces the efficacy of the procedure due to greater indication of choledocotomy, with complications and longer length of hospital stay.

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