Major bile duct injuries after laparoscopic cholecystectomy
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Major bile duct injuries after laparoscopic cholecystectomy : a tertiary center experience. / Frilling, Andrea; Li, Jun; Weber, Frank; Frühauf, Nils Roman; Engel, Jennifer; Beckebaum, Susanne; Paul, Andreas; Zöpf, Thomas; Malago, Massimo; Broelsch, Christoph Erich.
in: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, Jahrgang 8, Nr. 6, 11.09.2004, S. 679-85.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Major bile duct injuries after laparoscopic cholecystectomy
T2 - a tertiary center experience
AU - Frilling, Andrea
AU - Li, Jun
AU - Weber, Frank
AU - Frühauf, Nils Roman
AU - Engel, Jennifer
AU - Beckebaum, Susanne
AU - Paul, Andreas
AU - Zöpf, Thomas
AU - Malago, Massimo
AU - Broelsch, Christoph Erich
PY - 2004/9/11
Y1 - 2004/9/11
N2 - Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Several series have described a 0.5% to 1.4% incidence of bile duct injuries during laparoscopic cholecystectomy. The aim of this study was to report on an institutional experience with the management of complex bile duct injuries and outcome after surgical repair. Data were collected prospectively from 40 patients with bile duct injuries referred for surgical treatment to our center between April 1998 and December 2003. Prior to referral, 35 patients (87.5%) underwent attempts at surgical reconstruction at the primary hospital. In 77.5% of the patients, complex type E1 or type E2 BDI was found. Concomitant with bile duct injury, seven patients had vascular injuries. Roux-en-Y hepaticojejunostomy was carried out in 33 patients. In two patients, Roux-en-Y hepaticojejunostomy and vascular reconstruction were necessary. Five patients, one with primary nondiagnosed Klatskin tumor, required right hepatectomy. Two patients, both with bile duct injuries and vascular damage, died postoperatively. Because of progressive liver insufficiency, one of them was listed for high-urgency liver transplantation but died prior to intervention. At the median follow-up of 589 days, 82.5% of the patients are in excellent general condition. Seven patients have signs of chronic cholangitis. Major bile duct injuries remain a significant cause of morbidity and even death after laparoscopic cholecystectomy. Because they present a considerable surgical challenge, early referral to an experienced hepatobiliary center is recommended.
AB - Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Several series have described a 0.5% to 1.4% incidence of bile duct injuries during laparoscopic cholecystectomy. The aim of this study was to report on an institutional experience with the management of complex bile duct injuries and outcome after surgical repair. Data were collected prospectively from 40 patients with bile duct injuries referred for surgical treatment to our center between April 1998 and December 2003. Prior to referral, 35 patients (87.5%) underwent attempts at surgical reconstruction at the primary hospital. In 77.5% of the patients, complex type E1 or type E2 BDI was found. Concomitant with bile duct injury, seven patients had vascular injuries. Roux-en-Y hepaticojejunostomy was carried out in 33 patients. In two patients, Roux-en-Y hepaticojejunostomy and vascular reconstruction were necessary. Five patients, one with primary nondiagnosed Klatskin tumor, required right hepatectomy. Two patients, both with bile duct injuries and vascular damage, died postoperatively. Because of progressive liver insufficiency, one of them was listed for high-urgency liver transplantation but died prior to intervention. At the median follow-up of 589 days, 82.5% of the patients are in excellent general condition. Seven patients have signs of chronic cholangitis. Major bile duct injuries remain a significant cause of morbidity and even death after laparoscopic cholecystectomy. Because they present a considerable surgical challenge, early referral to an experienced hepatobiliary center is recommended.
KW - Adult
KW - Aged
KW - Anastomosis, Roux-en-Y
KW - Bile Ducts
KW - Cholangiopancreatography, Endoscopic Retrograde
KW - Cholecystectomy, Laparoscopic
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Reconstructive Surgical Procedures
KW - Treatment Outcome
KW - Wounds and Injuries
KW - Journal Article
U2 - 10.1016/j.gassur.2004.04.005
DO - 10.1016/j.gassur.2004.04.005
M3 - SCORING: Journal article
C2 - 15358328
VL - 8
SP - 679
EP - 685
JO - J GASTROINTEST SURG
JF - J GASTROINTEST SURG
SN - 1091-255X
IS - 6
ER -
