Excision of a Part of the Bile Duct As an Iatrogenic Injury Typical for Laparoscopic Cholecystectomy - Characteristics, Treatment and Long-term Results, Based on Own Material

Overview

Journal Wideochir Inne Tech Maloinwazyjne

Publisher Termedia

Date 2020 Mar 3

PMID 32117488

Citations 2

Authors

Sergiusz Durowicz

Ireneusz Kozicki

Adam Ciesielski

Wieslaw Tarnowski

Affiliations

Soon will be listed here.

Abstract

Introduction: Cholecystectomy is associated with the risk of bile duct injury (BDI). The nature of the injury in laparoscopic cholecystectomy (LC) cases seems to be more serious.

Aim: We present an analysis of long-term results of the treatment of patients who underwent operations at our department due to iatrogenic excision of a part of the bile duct (EPBD).

Material And Methods: Out of all 120 patients treated for BDI in our department we selected a group of 40 with EPBD. In all cases the corrective operation was hepaticojejunostomy. The median follow-up time was 157 (56-249) months. We evaluated risk factors for EPBD during LC compared to open cholecystectomy (OC).

Results: Among bile duct injuries referred to our centre, EPBD occurred more frequently during LC (46.7%) compared to OC (11%), p < 0.001. Injuries located in the hepatic hilum occurred more often in the case of LC (68.6%) than OC (20%), p = 0.056. We did not find a difference in the frequency of EPBD between LC and OC groups depending on the presence of acute or chronic cholecystitis. The narrow common hepatic duct was reported more frequently in the LC (68.6%) vs. OC (20%) group, p = 0.056. Satisfactory long-term reconstructive treatment results were observed in 36 (90%) of 40 patients.

Conclusions: Excision of a part of the bile duct occurs more often during LC than OC. It is often located in the hepatic hilum. Presence of a narrow common hepatic duct is a risk factor for EPBD during LC. Large diameter hepaticojejunostomy is a reconstructive procedure that promises good long-term results.

Citing Articles

A Novel End-to-End Biliary-to-Biliary Anastomosis Technique for Iatrogenic Bile Duct Injury of Strasberg-Bismuth E1-4 Treatment: A Retrospective Study and Assessment.

Ma D, Liu P, Lan J, Chen B, Gu Y, Li Y Front Surg. 2021; 8:747304.

PMID: 34778361 PMC: 8580848. DOI: 10.3389/fsurg.2021.747304.

The evaluation of B-SAFE and ultrasonographic landmarks in safe orientation during laparoscopic cholecystectomy.

Sebastian M, Sebastian A, Rudnicki J Wideochir Inne Tech Maloinwazyjne. 2020; 15(4):546-552.

PMID: 33294068 PMC: 7687673. DOI: 10.5114/wiitm.2020.100972.

References

Lillemoe K . Evaluation of suspected bile duct injuries. Surg Endosc. 2006; 20(11):1638-43. DOI: 10.1007/s00464-006-0489-2. View

Fazeli M, Kazemeini A, Jafarian A, Bashashati M, Keramati M . Temporary Trans-jejunal Hepatic Duct Stenting in Roux-en-y Hepaticojejunostomy for Reconstruction of Iatrogenic Bile Duct Injuries. Trauma Mon. 2016; 21(2):e21115. PMC: 5003501. DOI: 10.5812/traumamon.21115. View

Strasberg S, Hertl M, Soper N . An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995; 180(1):101-25. View

Suzuki H, Shimura T, Mochhida Y, Wada S, Araki K, Kubo N . To Stent or Not To Stent Hepaticojejunostomy--Analysis of Risk Factors for Postoperative Bile Leaks and Surgical Complication. Hepatogastroenterology. 2015; 61(132):920-6. View

Strasberg S, Helton W . An analytical review of vasculobiliary injury in laparoscopic and open cholecystectomy. HPB (Oxford). 2010; 13(1):1-14. PMC: 3019536. DOI: 10.1111/j.1477-2574.2010.00225.x. View

Winslow E, Fialkowski E, Linehan D, Hawkins W, Picus D, Strasberg S . "Sideways": results of repair of biliary injuries using a policy of side-to-side hepatico-jejunostomy. Ann Surg. 2009; 249(3):426-34. DOI: 10.1097/SLA.0b013e31819a6b2e. View

Sahbaz N, Peker K, Kabuli H, Gumusoglu A, Alis H . Single center experience in laparoscopic treatment of gallbladder perforation. Wideochir Inne Tech Maloinwazyjne. 2018; 12(4):372-377. PMC: 5776488. DOI: 10.5114/wiitm.2017.72321. View

Branum G, Schmitt C, Baillie J, Suhocki P, Baker M, Davidoff A . Management of major biliary complications after laparoscopic cholecystectomy. Ann Surg. 1993; 217(5):532-40; discussion 540-1. PMC: 1242839. DOI: 10.1097/00000658-199305010-00014. View

Kaman L, Sanyal S, Behera A, Singh R, Katariya R . Comparison of major bile duct injuries following laparoscopic cholecystectomy and open cholecystectomy. ANZ J Surg. 2006; 76(9):788-91. DOI: 10.1111/j.1445-2197.2006.03868.x. View

10.

Thompson C, Saad N, Quazi R, Darcy M, Picus D, Menias C . Management of iatrogenic bile duct injuries: role of the interventional radiologist. Radiographics. 2013; 33(1):117-34. DOI: 10.1148/rg.331125044. View

11.

Connor S, Garden O . Bile duct injury in the era of laparoscopic cholecystectomy. Br J Surg. 2006; 93(2):158-68. DOI: 10.1002/bjs.5266. View

12.

Strasberg S . Biliary injury in laparoscopic surgery: part 1. Processes used in determination of standard of care in misidentification injuries. J Am Coll Surg. 2005; 201(4):598-603. DOI: 10.1016/j.jamcollsurg.2005.05.009. View

13.

Nuzzo G, Giuliante F, Giovannini I, Murazio M, DAcapito F, Ardito F . Advantages of multidisciplinary management of bile duct injuries occurring during cholecystectomy. Am J Surg. 2008; 195(6):763-9. DOI: 10.1016/j.amjsurg.2007.05.046. View

14.

Mercado M, Chan C, Salgado-Nesme N, Lopez-Rosales F . Intrahepatic repair of bile duct injuries. A comparative study. J Gastrointest Surg. 2007; 12(2):364-8. DOI: 10.1007/s11605-007-0428-0. View

15.

Murr M, Gigot J, Nagorney D, Harmsen W, Ilstrup D, Farnell M . Long-term results of biliary reconstruction after laparoscopic bile duct injuries. Arch Surg. 1999; 134(6):604-9; discussion 609-10. DOI: 10.1001/archsurg.134.6.604. View

16.

Stewart L, Way L . Laparoscopic bile duct injuries: timing of surgical repair does not influence success rate. A multivariate analysis of factors influencing surgical outcomes. HPB (Oxford). 2009; 11(6):516-22. PMC: 2756640. DOI: 10.1111/j.1477-2574.2009.00096.x. View

17.

Stewart L, Way L . Bile duct injuries during laparoscopic cholecystectomy. Factors that influence the results of treatment. Arch Surg. 1995; 130(10):1123-8; discussion 1129. DOI: 10.1001/archsurg.1995.01430100101019. View

18.

McMahon A, Fullarton G, Baxter J, ODwyer P . Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg. 1995; 82(3):307-13. DOI: 10.1002/bjs.1800820308. View

19.

Eikermann M, Siegel R, Broeders I, Dziri C, Fingerhut A, Gutt C . Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2012; 26(11):3003-39. DOI: 10.1007/s00464-012-2511-1. View

20.

Sowier S, Sowier A, Wiechowska-Kozlowska A, Bialecki J, Pyda P . Initial experience with endoscopic ultrasound-guided gallbladder drainage. Wideochir Inne Tech Maloinwazyjne. 2019; 14(2):195-202. PMC: 6528133. DOI: 10.5114/wiitm.2018.79528. View