Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center.

Details

Serval ID
serval:BIB_B609D6782A17
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center.
Journal
Bioscience trends
Author(s)
Martin D., Uldry E., Demartines N., Halkic N.
ISSN
1881-7823 (Electronic)
ISSN-L
1881-7815
Publication state
Published
Issued date
19/07/2016
Peer-reviewed
Oui
Volume
10
Number
3
Pages
197-201
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Incidence of bile duct injuries (BDI) is low but remains a dramatic complication after laparoscopic cholecystectomy (LC). This study aimed to assess BDI incidence and management strategies. All patients treated in our institution for BDI after LC between 2000 and 2011 were retrospectively analyzed. Patients referred from others centers were excluded. Strasberg classification was used to determine the type of lesion. Thirteen patients presented iatrogenic BDI among 2,840 consecutive cholecystectomies performed (0.46%). Four cases were classified Strasberg type A, 4 type D, and 5 type E. Injury was recognized intraoperatively in 6 cases (46%). Three of these 6 required conversions to open surgery and all but one were primary sutured on a drain; the remaining patient required immediate biliodigestive anastomosis. In 7 patients, the injury was discovered postoperatively (54%). Among them, one was treated by direct closure of a cystic leak through immediate re-laparoscopy. Six underwent initially main bile duct stenting, but 4 required delayed secondary surgery (mean time 115 days), 2 to improve bile duct drainage and 2 for biliodigestive derivation. BDI incidence remains low but management depends on the time of diagnosis. BDI are complex and require tailored treatment usually in a tertiary center for a multidisciplinary approach.
Keywords
Adult, Aged, Aged, 80 and over, Bile Ducts/injuries, Bile Ducts/surgery, Cholecystectomy, Laparoscopic/adverse effects, Female, Humans, Incidence, Male, Middle Aged, Postoperative Complications/diagnosis, Postoperative Complications/epidemiology, Postoperative Complications/surgery, Retrospective Studies, Tertiary Care Centers, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
11/10/2018 15:34
Last modification date
20/08/2019 15:24
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