IJCM  Vol.6 No.11 , November 2015
The Clinical Analysis of Bile Duct Injury during Laparoscopic Cholecystectomy
ABSTRACT
The study was to improve surgical safety and reduce the incidence of bile duct injury (BDI) during laparoscopic cholecystectomy. The clinical information of 31 cases with bile duct injury during Laparoscopic Cholecystectomy (LC) was analyzed retrospectively. Thirty patients with bile duct injury were divided into 5 types according to Bismuth typing, including: type I 9 cases, type II 12 cases, type III 4 cases, type IV 3 cases, type V 3 cases. After median follow-up of 48 months, 30 (97%) patients are alive and 29 (94%) remain in good general condition with normal liver function. One patient died from acute obstructive suppurative cholangitis (AOSC). One patient appeared to have pain under the xiphoid that was resolved after 3 months. Recurrent strictures following repair have developed in two (6%) patients with high injuries combined with right hepatic arterial injury. Appropriate surgical indications, handling Calot triangle carefully and correctly, and conversion to open surgery at the right moment are the keys of prevention and treatment of bile duct injury during LC.

Cite this paper
Gao, Z. , Li, P. , Chen, F. and Tan, D. (2015) The Clinical Analysis of Bile Duct Injury during Laparoscopic Cholecystectomy. International Journal of Clinical Medicine, 6, 825-830. doi: 10.4236/ijcm.2015.611108.
References
[1]   Ou, Z.B., Li, S.W., Liu, C.A., Tu, B., Wu, C.X., Ding, X., et al. (2009) Prevention of Common Bile Duct Injury during Laparoscopic Cholecystectomy. Hepatobiliary & Pancreatic Diseases International: HBPD INT, 8, 414-417.

[2]   Lau, K.N., Sindram, D., Agee, N., Martinie, J.B. and Iannitti, D.A. (2010) Bile Duct Injury after Single Incision Laparoscopic Cholecystectomy. JSLS: Journal of the Society of Laparoendoscopic Surgeons/Society of Laparoendoscopic Surgeons, 14, 587-591.
http://dx.doi.org/10.4293/108680810X12924466008646

[3]   Joseph, M., Phillips, M.R., Farrell, T.M. and Rupp, C.C. (2012) Single Incision Laparoscopic Cholecystectomy Is Associated with a Higher Bile Duct Injury Rate: A Review and a Word of Caution. Annals of Surgery, 256, 1-6.
http://dx.doi.org/10.1097/SLA.0b013e3182583fde

[4]   Al-Kubati, W.R. (2010) Bile Duct Injuries Following Laparoscopic Cholecystectomy: A Clinical Study. Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association, 16, 100-104.
http://dx.doi.org/10.4103/1319-3767.61236

[5]   Buddingh, K.T., Nieuwenhuijs, V.B., van Buuren, L., Hulscher, J.B., de Jong, J.S. and van Dam, G.M. (2011) Intraoperative Assessment of Biliary Anatomy for Prevention of Bile Duct Injury: A Review of Current and Future Patient Safety Interventions. Surgical Endoscopy, 25, 2449-2461.
http://dx.doi.org/10.1007/s00464-011-1639-8

[6]   Strasberg, S.M. (2013) A Teaching Program for the “Culture of Safety in Cholecystectomy” and Avoidance of Bile Duct Injury. Journal of the American College of Surgeons, 217, 751.
http://dx.doi.org/10.1016/j.jamcollsurg.2013.05.001

[7]   Soper, N.J. (2011) Prevention of Biliary Leaks. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 15, 1005-1006.
http://dx.doi.org/10.1007/s11605-011-1512-z

[8]   Huang, Q., Liu, C.H., Zhu, C.L., Xie, F. and Hu, S.Y. (2013) The Choice of Surgical Timing for Biliary Duct Reconstruction after Obstructive Bile Duct Injury: An Experimental Study. Hepato-Gastroenterology.

[9]   Lau, W.Y., Lai, E.C. and Lau, S.H. (2010) Management of Bile Duct Injury after Laparoscopic Cholecystectomy: A Review. ANZ Journal of Surgery, 80, 75-81.
http://dx.doi.org/10.1111/j.1445-2197.2009.05205.x

[10]   Nordin, A., Gronroos, J.M. and Makisalo, H. (2011) Treatment of Biliary Complications after Laparoscopic Cholecystectomy. Scandinavian Journal of Surgery: SJS: Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society, 100, 42-48.

[11]   Karvonen, J., Gronroos, J.M., Makitalo, L., Koivisto, M. and Salminen, P. (2013) Quality of Life after Iatrogenic Bile Duct Injury—A Case Control Study. Minimally Invasive Therapy & Allied Technologies, 22, 177-180.
http://dx.doi.org/10.3109/13645706.2012.752751

[12]   Thompson, C.M., Saad, N.E., Quazi, R.R., Darcy, M.D., Picus, D.D. and Menias, C.O. (2013) Management of Iatrogenic Bile Duct Injuries: Role of the Interventional Radiologist. Radiographics, 33, 117-134.

[13]   Xu, X.D., Zhang, Y.C., Gao, P., Bahrani-Mougeot, F., Zhang, L.Y., He, Z.Y., et al. (2011) Treatment of Major Laparoscopic Bile Duct Injury: A Long-Term Follow-Up Result. The American Surgeon, 77, 1584-1588.

[14]   Lovecek, M., Havlik, R., Klein, J., Maly, T., Kocher, M., Cerna, M., et al. (2010) Iatrogenic Bile Ducts Injuries. Rozhledy v Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti, 89, 183-187.

[15]   Macedo, F.I., Casillas, V.J., Davis, J.S., Levi, J.U. and Sleeman, D. (2013) Biliary-Colonic Fistula Caused by Cholecystectomy Bile Duct Injury. Hepatobiliary & Pancreatic Diseases International, 12, 443-445.
http://dx.doi.org/10.1016/S1499-3872(13)60070-3

[16]   Lubikowski, J., Post, M., Bialek, A., Kordowski, J., Milkiewicz, P. and Wojcicki, M. (2011) Surgical Management and Outcome of Bile Duct Injuries Following Cholecystectomy: A Single-Center Experience. Langenbeck’s Archives of Surgery, 396, 699-707.
http://dx.doi.org/10.1007/s00423-011-0745-3

[17]   Harrison, V.L., Dolan, J.P., Pham, T.H., Diggs, B.S., Greenstein, A.J., Sheppard, B.C., et al. (2011) Bile Duct Injury after Laparoscopic Cholecystectomy in Hospitals with and without Surgical Residency Programs: Is There a Difference? Surgical Endoscopy, 25, 1969-1974.
http://dx.doi.org/10.1007/s00464-010-1495-y

[18]   Pesce, A., Portale, T.R., Minutolo, V., Scilletta, R., Li Destri, G. and Puleo, S. (2012) Bile Duct Injury during Laparoscopic Cholecystectomy without Intraoperative Cholangiography: A Retrospective Study on 1,100 Selected Patients. Digestive Surgery, 29, 310-314.
http://dx.doi.org/10.1159/000341660

[19]   Tantia, O., Sasmal, P.K., Patle, N. and Prasad, P. (2010) Bile Duct Injury during Laparoscopic Cholecystectomy: Mechanism and Prevention. Journal of the Indian Medical Association, 108, 667-668, 671.

[20]   Fullum, T.M., Downing, S.R., Ortega, G., Chang, D.C., Oyetunji, T.A., Van Kirk, K., et al. (2013) Is Laparoscopy a Risk Factor for Bile Duct Injury during Cholecystectomy? JSLS: Journal of the Society of Laparoendoscopic Surgeons, 17, 365-370.
http://dx.doi.org/10.4293/108680813X13654754535638

[21]   Tian, Y., Wu, S.D., Su, Y., Kong, J., Yu, H. and Fan, Y. (2009) Laparoscopic Subtotal Cholecystectomy as an Alternative Procedure Designed to Prevent Bile Duct Injury: Experience of a Hospital in Northern China. Surgery Today, 39, 510-513.
http://dx.doi.org/10.1007/s00595-008-3916-2

 
 
Top