Iatrogenic Bile Duct Injury Following Open and Laparoscopic Cholecystectomy and Treatment Outcome

2018 ◽  
Vol 23 (1) ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Treatment Outcome ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Iatrogenic Bile Duct Injury

scholarly journals Iatrogenic Bile Duct Injuries: An Overview and A Review of Literature

2021 ◽  
Vol 07 (01) ◽  
pp. 037-043
Author(s):  
Vinoth M. ◽  
Abhijit Joshi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Surgical Procedures ◽  
Surgical Repair ◽  
Review Of Literature ◽  
Bile Duct Injuries ◽  
Iatrogenic Bile Duct Injury

Abstract​ Laparoscopic cholecystectomy (LC) is one of the most frequently performed surgical procedures worldwide. Iatrogenic bile duct injury (IBDI) is a serious complication of LC and has an incidence of 0.3 to 0.7%. Since it is associated with a significant and potentially lifelong morbidity as well as mortality, diagnosing IBDI as early as possible is of paramount importance. Management of bile duct injuries and prognosis of their surgical repair depend on the timing of its recognition, type and the extent of the injury. In this paper, we present a case of IBDI and attempt to discuss all its dimensions.

Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Department's Own Material

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Retrospective Analysis ◽  
Bile Duct Injury ◽  
Clinical Symptoms ◽  
Open Cholecystectomy ◽  
Multidisciplinary Treatment ◽  
Laparoscopic Technique ◽  
Primary Surgery ◽  
Iatrogenic Bile Duct Injury

AbstractIatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased.was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014.. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay.. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%).. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.

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

Is the Age of Patients with Iatrogenic Bile Duct Injuries Increasing?

2015 ◽  
Vol 87 (3) ◽  
Author(s):  
Rafał Stankiewicz ◽  
Bogusław Najnigier ◽  
Marek Krawczyk
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Elderly Person ◽  
Reference Centre ◽  
Bile Duct Injuries ◽  
Gender And Age ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
The Mean ◽  
Iatrogenic Bile Duct Injury

AbstractResection of the gall-bladder is still the most common surgical procedure performed at general surgery departments. The laparoscopic method used in the majority of cases offers considerable benefits but at the same time is associated with an increased rate of bile duct complications. So far, a slim female aged 25-50 years was a typical patient with a iatrogenic bile duct injury.The aim of the study was to identify the age of patients with iatrogenic bile duct injuries as well as the clinical course observed in recent years.Material and methods. Gender and age structure of patients admitted to the Department of General, Transplant and Liver Surgery between the beginning of 2011 and June 2014 and treated for iatrogenic bile duct injuries, complications of laparoscopic cholecystectomy, were analysed. The patients were referred to the department as a reference centre.Results. In the group of 186 patients, females predominated (69.4%) and the mean age was 52 years. A considerable increase in the mean age of patients treated in 2014 as compared with previous years was seen. This was related to an increased rate of bile duct injuries in patients aged over 70 years, who accounted for about 25% of the group. In previous years, bile duct injuries in patients of such an advanced age happened considerably less frequently.Conclusions. A iatrogenic bile duct injury in an elderly person may prove a fatal complication. A repair surgery, i.e. the biliary-enteric anastomosis, is a major and burdensome procedure, particularly in the case of patients aged over 70 years. Special caution during laparoscopic cholecystectomy is advised in this population, and the slightest doubts should lead to conversion.

Iatrogenic bile duct injury: The scourge of laparoscopic cholecystectomy

2002 ◽  
Vol 72 (2) ◽  
pp. 83-88 ◽  
Author(s):  
K. Slater ◽  
R. W. Strong ◽  
D. R. Wall ◽  
S. V. Lynch
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Iatrogenic Bile Duct Injury

scholarly journals Early laparoscopic primary repair of an iatrogenic bile duct injury during laparoscopic cholecystectomy

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e805-e806
Author(s):  
G. Sergeant ◽  
W. Bouckaert ◽  
J. Degols ◽  
B. Houben ◽  
J. Knol ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Primary Repair ◽  
Iatrogenic Bile Duct Injury
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