Bile duct injury and bile leakage in laparoscopic cholecystectomy

1995 ◽  
Vol 82 (8) ◽  
pp. 1144-1144
Author(s):  
H. Yamauchi ◽  
E. Kobayashi ◽  
Y. Suminaga ◽  
T. Yoshida ◽  
T. Kai ◽  
...  
2018 ◽  
Vol 30 (2) ◽  
pp. 95-97
Author(s):  
Md Rafiqul Islam ◽  
Md Showkat Ali ◽  
SM Golam Azam

Bile duct injury is one of a life threatening complication of laparoscopic cholecystectomy. It is a disaster for both patient and surgeon because of the associated morbidity, prolonged hospitalization and mortality. The complication can be minimized by early diagnosis and treatment. Minor injury can be managed by conservative treatment. Bile in drainage tube is diagnostic. Minimum bile leakage automatically sealed provided the natural passage remain patent. Further bile leakage can be reduced by stenting the common bile duct by ERCP. Major bile duct injury needs early diagnosis, categorization of level of injury, control of sepsis and some form of surgical intervention. Early referral to tertiary level hospital under experienced hepatobiliary surgeon will give the good result.Medicine Today 2018 Vol.30(2): 95-97


1993 ◽  
Vol 80 (12) ◽  
pp. 1590-1592 ◽  
Author(s):  
S.-M. Huang ◽  
C.-W. Wu ◽  
H.-T. Hong ◽  
Ming-Liu ◽  
K.-L. King ◽  
...  

1995 ◽  
Vol 82 (3) ◽  
pp. 307-313 ◽  
Author(s):  
A. J. McMahon ◽  
G. Fullarton ◽  
J. N. Baxter ◽  
P. J. O'Dwyer

2021 ◽  
Vol 07 (01) ◽  
pp. 037-043
Author(s):  
Vinoth M. ◽  
Abhijit Joshi

Abstract​ Laparoscopic cholecystectomy (LC) is one of the most frequently performed surgical procedures worldwide. Iatrogenic bile duct injury (IBDI) is a serious complication of LC and has an incidence of 0.3 to 0.7%. Since it is associated with a significant and potentially lifelong morbidity as well as mortality, diagnosing IBDI as early as possible is of paramount importance. Management of bile duct injuries and prognosis of their surgical repair depend on the timing of its recognition, type and the extent of the injury. In this paper, we present a case of IBDI and attempt to discuss all its dimensions.


2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  

AbstractIatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased.was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014.. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay.. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%).. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.


Author(s):  
Lygia Stewart ◽  
Lawrence W. Way

Application of human factors concepts to high-risk activities has facilitated reduction in human error. With introduction of laparoscopic cholecystectomy, the incidence of bile duct injury increased. Seeking ideas for prevention, we analyzed 300 laparoscopic bile duct injuries within the framework of human error analysis. The primary cause of error (97%) was a visual perceptual illusion. The laparoscopic environment contributed to 75% of injuries, poor visibility 22%. Most injuries involved deliberate major bile duct transection due to misperception of the anatomy. This illusion was so compelling that the surgeon usually did not recognize it. Even when irregular cues were detected, improper rules were employed, eliminating feedback. Since the complication-causing error occurred at few key steps during laparoscopic cholecystectomy; we instituted focused training to heighten vigilance, and have formulated specific rules to decrease the incidence of bile duct injury. In addition, factors in the laparoscopic environment contributing to this illusion are discussed.


HPB ◽  
2020 ◽  
Author(s):  
Chetanya Sharma ◽  
Harsmirat Singh ◽  
Felipe Orihuela-Espina ◽  
Ara Darzi ◽  
Mikael H. Sodergren

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