Late two-stage laparoscopic cholecystectomy is associated with an increased risk of major bile duct injury

2015 ◽  
Vol 86 (1-2) ◽  
pp. 63-68 ◽  
Author(s):  
Andrei M. Beliaev ◽  
Michael Booth
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Two Stage ◽  
Increased Risk

Native Americans Have an Increased Risk of Major Bile Duct Injury during Laparoscopic Cholecystectomy: Results from a Statewide Analysis

2017 ◽  
Vol 83 (4) ◽  
pp. 110-112
Author(s):  
Alissa Greenbaum ◽  
Eyas Alkhalili ◽  
Li Luo ◽  
Ashwani Rajput ◽  
Itzhak Nir
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Native Americans ◽  
Bile Duct Injury ◽  
Increased Risk

scholarly journals Fluorescent Imaging With Indocyanine Green During Laparoscopic Cholecystectomy in Patients at Increased Risk of Bile Duct Injury

2017 ◽  
Vol 24 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Marjolein Ankersmit ◽  
Dieuwertje A. van Dam ◽  
Anne-Sophie van Rijswijk ◽  
Baukje van den Heuvel ◽  
Jurriaan B. Tuynman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Indocyanine Green ◽  
Bile Duct Injury ◽  
Near Infrared ◽  
Fluorescent Imaging ◽  
Added Value ◽  
Optimal Dosage ◽  
Nir Light ◽  
Increased Risk

Background. Although rare, injury to the common bile duct (CBD) during laparoscopic cholecystectomy (LC) can be reduced by better intraoperative visualization of the cystic duct (CD) and CBD. The aim of this study was to establish the efficacy of early visualization of the CD and the added value of CBD identification, using near-infrared (NIR) light and the fluorescent agent indocyanine green (ICG), in patients at increased risk of bile duct injury. Materials and Methods. Patients diagnosed with complicated cholecystitis and scheduled for LC were included. The CBD and CD were visualized with NIR light before and during dissection of the liver hilus and at critical view of safety (CVS). Results. Of the 20 patients originally included, 2 were later excluded due to conversion. In 6 of 18 patients, the CD was visualized early during dissection and prior to imaging with conventional white light. The CBD was additionally visualized with ICG-NIR in 7 of 18 patients. In 1 patient, conversion was prevented due to detection of the CD and CBD with ICG-NIR. Conclusions. Early visualization of the CD or additional identification of the CBD using ICG-NIR in patients with complicated cholecystolithiasis can be helpful in preventing CBD injury. Future studies should attempt to establish the optimal dosage and time frame for ICG administration and bile duct visualization with respect to different gallbladder pathologies.

scholarly journals Biliary Complications Post Laparoscopic Cholecystectomy: Mechanism, Preventive Measures, and Approach to Management: A Review

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Norman Oneil Machado
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Preventive Measures ◽  
Hepatic Duct ◽  
Biliary Complications ◽  
Common Hepatic Duct ◽  
Management Approach ◽  
Open Approach ◽  
Increased Risk

Laparoscopic cholecystectomy has emerged as a gold standard therapeutic option for the management of symptomatic cholelithiasis. However, adaptation of LC is associated with increased risk of complications, particularly bile duct injury ranging from 0.3 to 0.6%. Occurrence of BDI results in difficult reconstruction, prolonged hospitalization, and high risk of long-term complications. Therefore, more emphasis is placed on preventing these complications. In addition to adequate training, several techniques have been proposed to prevent bile duct injury including use of 30∘ scope, adequate delineation of structures in Calot's triangle (critical view), avoidance of diathermy close to common hepatic duct, and intraoperative cholangiogram, and to maintain a low threshold to conversion to open approach when uncertain. Management of Bile duct injury depends on the nature of injury, time of detection, and the expertise available, and would range from simple subhepatic drainage to Roux-en-Y hepaticojejunostomy particularly performed at specialised centers. This article based on the literature review aims to review the biliary complications following laparoscopic cholecystectomy with reference to its mechanism , preventive measures to be taken, and the management approach.

scholarly journals Iatrogenic Bile Duct Injuries: An Overview and A Review of Literature

2021 ◽  
Vol 07 (01) ◽  
pp. 037-043
Author(s):  
Vinoth M. ◽  
Abhijit Joshi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Surgical Procedures ◽  
Surgical Repair ◽  
Review Of Literature ◽  
Bile Duct Injuries ◽  
Iatrogenic Bile Duct Injury

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.

Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Department's Own Material

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Retrospective Analysis ◽  
Bile Duct Injury ◽  
Clinical Symptoms ◽  
Open Cholecystectomy ◽  
Multidisciplinary Treatment ◽  
Laparoscopic Technique ◽  
Primary Surgery ◽  
Iatrogenic Bile Duct Injury

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.

The Prevention of Laparoscopic Bile Duct Injuries: An Analysis of 300 Cases of from a Human Factors and Cognitive Psychology Perspective

2007 ◽  
Vol 51 (11) ◽  
pp. 617-620 ◽  
Author(s):  
Lygia Stewart ◽  
Lawrence W. Way
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Human Factors ◽  
Bile Duct Injury ◽  
Human Error ◽  
Perceptual Illusion ◽  
Bile Duct Injuries ◽  
Psychology Perspective ◽  
Cause Of Error ◽  
Key Steps

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.

Visual gaze patterns reveal surgeons’ ability to identify risk of bile duct injury during laparoscopic cholecystectomy

HPB ◽  
2020 ◽  
Author(s):  
Chetanya Sharma ◽  
Harsmirat Singh ◽  
Felipe Orihuela-Espina ◽  
Ara Darzi ◽  
Mikael H. Sodergren
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Gaze Patterns ◽  
Visual Gaze

Laparoscopic cholecystectomy — key technical points to prevent bile duct injury

1994 ◽  
Vol 1 (3) ◽  
pp. 314-318 ◽  
Author(s):  
Nobuyasu Kano ◽  
Tatsuo Yamakawa ◽  
Yasuro Ishikawa ◽  
Shigeru Sakai ◽  
Hiraku Honda ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury
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