scholarly journals Injuries during Laparoscopic Cholecystectomy: A Scoping Review of the Claims and Civil Action Judgements

2021 ◽  
Vol 10 (22) ◽  
pp. 5238
Author(s):  
Roberto Cirocchi ◽  
Laura Panata ◽  
Ewen A. Griffiths ◽  
Giovanni D. Tebala ◽  
Massimo Lancia ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Scoping Review ◽  
Operative Management ◽  
Hepatic Bile ◽  
Surgical Performance ◽  
Civil Action ◽  
Common Cause ◽  
Hepatic Bile Duct ◽  
Presurgical Assessment

Background. To define what type of injuries are more frequently related to medicolegal claims and civil action judgments. Methods. We performed a scoping review on 14 studies and 2406 patients, analyzing medicolegal claims related to laparoscopic cholecystectomy injuries. We have focalized on three phases associated with claims: phase of care, location of injuries, type of injuries. Results. The most common phase of care associated with litigation was the improper intraoperative surgical performance (47.6% ± 28.3%), related to a “poor” visualization, and the improper post-operative management (29.3% ± 31.6%). The highest rate of defense verdicts was reported for the improper post-operative management of the injury (69.3% ± 23%). A lower rate was reported in the incorrect presurgical assessment (39.7% ± 24.4%) and in the improper intraoperative surgical performance (21.39% ± 21.09%). A defense verdict was more common in cystic duct injuries (100%), lower in hepatic bile duct (42.9%) and common bile duct (10%) injuries. Conclusions. During laparoscopic cholecystectomy, the most common cause of claims, associated with lower rate of defense verdict, was the improper intraoperative surgical performance. The decision to take legal action was determined often for poor communication after the original incident.

Choledochogastric Fistula after Recurrent Acute Cholangitis Post-Cholecystectomy

2020 ◽  
Vol 3 (2) ◽  
pp. 01-03
Author(s):  
Ajda Altinoz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Cholangitis ◽  
Exploratory Laparotomy ◽  
Fistula Tract ◽  
Fistulous Opening ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Cbd Exploration

This is a case of a 46 years old male presented with acute cholangitis 2 years after laparoscopic cholecystectomy for cholecystolithiasis. He underwent biliary drainage and common bile duct (CBD) exploration for multiple stones at 2017. A year later, he presented with a recurrent acute cholangitis associated with choledocholithiasis and dilatation of left hepatic bile duct. Cholangiogram revealed that there is contract flowing to the stomach from the CBD, showing a choledochogastric fistula. Exploratory laparotomy was performed with CBD exploration with extraction of multiple stones, choledochoscopy and hepatojejunostomy. Insertion of PTC drain over a guidewire passed through a fistulous opening into the stomach. We decided on conservative management for fistula tract to heal.

scholarly journals Extra hepatic bile duct injury after laparoscopic cholecystectomy: a retrospective study

2020 ◽  
Vol 7 (8) ◽  
pp. 2517
Author(s):  
Ankit Gupta ◽  
Saurabh Agrawal ◽  
Namrata Sharma ◽  
Nakum Parth
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Surgical Techniques ◽  
Uttar Pradesh ◽  
Major Complication ◽  
Moderate Degree ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Bile Duct Injuries ◽  
Cbd Injury

Background: Laparoscopic cholecystectomy (LC), being one of the most common performed surgical procedure among the basic surgeries. Incidence of common bile duct (CBD) injury as high as 1.4-3% has been reported in some studies. The aim of this study was to estimate the incidence and predictors of CBD injury who underwent elective laparoscopic cholecystectomy.Methods: A retrospective observational study conducted at Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh India. Data was collected for a period of 1 year between March 2019 till 2020.Results: In majority of laparoscopic cholecystectomy we encountered moderate degree of difficulty. Extra hepatic bile duct injuries occurred in 1.4% of cases and were classified according to Strasberg classification. Type A injury was most common followed by type E2. Most major bile duct injuries were recognized intraoperatively. No mortality was noted in our study.Conclusions: Bile duct injuries is a major complication of laparoscopic cholecystectomy with significant morbidity and mortality, reduced survival impaired quality of life and subsequent litigations. Majority of bile duct injuries, results mainly from the surgeon’s inexperience, misinterpretation of anatomy and poor surgical techniques.

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

scholarly journals Evaluation of extra capsular lymph node involvement in patients with extra-hepatic bile duct cancer

2012 ◽  
Vol 10 (1) ◽  
Author(s):  
Takehiro Noji ◽  
Masaki Miyamoto ◽  
Kanako C Kubota ◽  
Toshiya Shinohara ◽  
Yoshiyasu Ambo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Bile Duct ◽  
Bile Duct Cancer ◽  
Lymph Node Involvement ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Node Involvement ◽  
Duct Cancer

scholarly journals Hepatolitiasis: Kasus Serial di RSUD Dr. Soetomo

2018 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Made Mahayasa ◽  
Tommy Lesmana
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Gall Bladder ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Common Hepatic Duct ◽  
Hepatic Bile ◽  
Hepatic Bile Duct

Latar Belakang: hepatolitiasis adalah batu empedu pada saluran empedu liver dengan insidensi 20-30% dari semua pasien yang menjalani operasi untuk penyakit batu empedu. Ada beberapa pilihan operasi hepatolitiasis, seperti hepatektomi, eksplorasi common bile duct (CBD), dan drainase saluran intrahepatik atau cholangioenterostomy (access loop procedures), dan teknik perkutaneus. Pada laporan kasus serial ini, akan dibahas aspek pemilihan operasi pada pasien dengan hepatolitiasis. Kasus: kasus pertama adalah laki-laki, 60 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan nyeri abdomen kuadran kanan atas sejak 2 minggu. Diagnosis dengan USG (ultrasonografi) abdomen dan MRCP (magnetic resonance cholangiopancreatography) menunjukkan terdapat beberapa batu di IHBD (intra hepatic bile duct), CHD (common hepatic duct), CBD, GB (gall bladder), dan sistem bilier yang melebar. Pada pasien dilakukan tindakan kolesistektomi, eksplorasi duktus, dan by pass bilio-digestive Roux en Y (access loop procedures). Kasus kedua adalah perempuan, 45 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan didiagnosis batu IHBD dan CBD. Penderita telah dilakukan kolesistektomi sejak 12 tahun yang lalu. Durante operasi ditemukan atrofi lobus kiri hati. Pada pasien, dilakukan operasi dengan eksplorasi duktus, by pass bilio-digestive Roux en Y (access loop procedures), dan hepatektomi lobus kiri. Simpulan: kasus hepatolitiasis jarang terjadi di Rumah Sakit Dr. Soetomo Surabaya. Diagnosis lengkap memerlukan kombinasi modalitas pencitraan. Pembedahan tetap menjadi pilihan utama pengobatan definitif. Menurut strategi terapeutik saat ini untuk hepatolitiasis, hepatektomi tampaknya merupakan pengobatan yang paling efektif untuk pasien dengan hepatolitiasis kiri yang terisolasi jika prosedur pembedahan lain tidak dapat mengatasi semua lesi terkait. Perawatan yang baik dapat memberikan luaran yang baik.

Hepatic Bile Duct Hamartomas (von Meyenburg Complexes): MR and MR Cholangiography Findings

2002 ◽  
Vol 26 (3) ◽  
pp. 438-443 ◽  
Author(s):  
Bart Mortelé ◽  
Koenraad Mortelé ◽  
Patrick Seynaeve ◽  
Dirk Vandevelde ◽  
Marc Kunnen ◽  
...  
Keyword(s):  
Bile Duct ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Mr Cholangiography
Sign in / Sign up

Export Citation Format

Share Document