Combined portal vein, hepatic artery and bile duct injury during open cholecystectomy

2021 ◽  
Author(s):  
Narendra Pandit ◽  
Tek Narayan Yadav ◽  
Kunal Bikram Deo ◽  
Laligen Awale ◽  
Lokesh Shekher Jaiswal
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Bile Duct Injury ◽  
Open Cholecystectomy

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.

Prolonged (Longer than 3 Hours) Laparoscopic Cholecystectomy: Reasons and Results

2011 ◽  
Vol 77 (8) ◽  
pp. 981-984 ◽  
Author(s):  
Gokulakkrishna Subhas ◽  
Aditya Gupta ◽  
Jasneet Bhullar ◽  
Linda Dubay ◽  
Lorenzo Ferguson ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Open Cholecystectomy ◽  
Stepwise Logistic Regression ◽  
Intraabdominal Adhesions ◽  
Average Operative Time ◽  
Prolonged Surgery

For the experienced surgeon, the average operative time for a laparoscopic cholecystectomy is less than 1 hour. There has been no study documenting the causes and results of prolonged (longer than 3 hours) surgery. A retrospective study was done of patients who underwent cholecystectomy between January 2003 and December 2007. A total of 3126 cholecystectomies were done. After excluding patients who had a planned open cholecystectomy and patients who had additional laparoscopic surgeries, we identified 70 patients who had a planned laparoscopic cholecystectomy with operative time exceeding 3 hours. Multivariate stepwise logistic regression was performed analyzing the various factors leading to prolonged surgery. Of the 70 patients, ranging in age from 21 to 92 years (mean, 57 years), most (n = 53) were female. Operative time ranged from 3 hours to 6 hours 40 minutes (mean, 3 hours 37 minutes). Emergency:elective admission ratio was 9:5 and acute cholecystitis (n = 40) was the most common indication. Common characteristics were obesity (n = 44, P = 0.031), intraabdominal adhesions (n = 43, P = 0.004), and previous abdominal surgeries (n = 40, P = 0.002). Intraoperative complications included spillage of stones (n = 6), bile duct injury (n = 3), and bleeding (n = 3). The possibility of prolonged laparoscopic cholecystectomy should be anticipated in patients with obesity and previous abdominal operations. Prolonged surgery increases the risk of complications (bile duct injury, bleeding) and prolongs the postoperative hospital stay.

Hepatic Resection Combined with Portal Vein or Hepatic Artery Reconstruction for Advanced Carcinoma of the Hilar Bile Duct and Gallbladder

2003 ◽  
Vol 27 (10) ◽  
pp. 1137-1142 ◽  
Author(s):  
Hiroshi Shimada ◽  
Itaru Endo ◽  
Mitsutaka Sugita ◽  
Hideki Masunari ◽  
Yoshiro Fujii ◽  
...  
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Resection ◽  
Hepatic Artery ◽  
Advanced Carcinoma ◽  
Hepatic Artery Reconstruction ◽  
Hilar Bile Duct ◽  
Artery Reconstruction

scholarly journals Laparoscopic subtotal cholecystectomy: a safe approach in difficult cholecystectomy

2019 ◽  
Vol 6 (5) ◽  
pp. 1767
Author(s):  
Hosni Mubarak Khan ◽  
Manjunath B. G. ◽  
Vasanth G. Shenoy
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Subtotal Cholecystectomy ◽  
Conversion Rates ◽  
Conversion To Open Cholecystectomy ◽  
Difficult Cholecystectomy ◽  
Symptomatic Gallstone Disease

Background: Laparoscopic cholecystectomy (LC) has been recognized as the new "gold standard" for the treatment of symptomatic gallstone disease. In order to prevent serious bile duct and vascular injuries, conversion is advocated for unclear anatomy at the Calot’s. Our aim was to assess the safety and effectiveness of laparoscopic subtotal cholecystectomy (LSC) in difficult cholecystectomy in order to reduce the incidence of bile duct injury and conversion rates.Methods: An analysis of retrospectively collected data of 452 patients who underwent LC was done at our Hospital during the period of January 2010 to December 2013. In few cases of difficult GB when Calot’s could not be dissected, laparoscopic retrograde cholecystectomy (LRC) was attempted and if that failed we adopted the technique of LSC.Results: A total of 452 patients were included. The median age was 48 years. All the 452 patients were posted for LC. Of the 452 patients, 404 patients underwent LC and the remaining 48 patients had difficult GB. Among the 48 patients having a difficult GB, 44 cases underwent LSC (3 cases underwent LSC Type-1 and 41 cases underwent LSC Type-2) and the remaining 4 cases underwent conversion to open cholecystectomy. The mean operative time was 130mins and median post op stay was 2 days.Conclusions: In our technique of LSC the conversion rates were <1% with no bile duct injury and believe that it is feasible and safe for operating on difficult GB’s.

scholarly journals Teratoma arising from hepato duodenal ligament in the newborn with transection of portal vein, hepatic artery and common bile duct: A surgical challenge

2018 ◽  
Vol 23 (1) ◽  
pp. 45 ◽  
Author(s):  
VR Ravikumar ◽  
G Rajamani ◽  
Vijayakumar Raju ◽  
Rajani Sundar ◽  
Sowmya Ravikumar ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery

Concurrent Biliary Disease Increases the Risk for Conversion and Bile Duct Injury in Laparoscopic Cholecystectomy: A Retrospective Analysis at a County Teaching Hospital

2017 ◽  
Vol 83 (10) ◽  
pp. 1024-1028 ◽  
Author(s):  
Lara H. Spence ◽  
Samuel Schwartz ◽  
Amy H. Kaji ◽  
David Plurad ◽  
Dennis Kim
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Biliary Tract ◽  
Bile Duct Injury ◽  
Odds Ratio ◽  
Open Cholecystectomy ◽  
Biliary Tract Disease ◽  
Endoscopic Retrograde ◽  
Conversion To Open Cholecystectomy ◽  
Tract Disease

Biliary tract disease remains a common indication for operative intervention. The incidence of concurrent biliary tract disease (>2 biliary tract disease processes) is unknown and the impact of more than one biliary tract diagnosis on outcomes remains to be defined. The objective of this study was to determine the effect of concurrent biliary tract disease on conversion rate and outcomes after laparoscopic cholecystectomy. A 5-year retrospective analysis of all patients who underwent a laparoscopic cholecystectomy was performed comparing those with a single biliary diagnosis to patients with concurrent biliary tract disease. Variables analyzed were conversion to open cholecystectomy, incidence of bile duct injury, use of endoscopic retrograde cholangiopancreatography and/or intraoperative cholangiogram, length of surgery, and duration of hospitalization. The incidence of concurrent biliary tract disease was 9 per cent and a conversion to open cholecystectomy was performed in 16 per cent of patients. After adjusting for confounding factors, concurrent biliary tract disease was predictive of conversion (odds ratio 1.6, 95% confidence interval 1.1–2.3, P = 0.03) and bile duct injury (odds ratio 2.5, 95% confidence interval 0.8–5, P = 0.01). Concurrent biliary tract disease patients were more likely to undergo intraoperative cholangiogram or endoscopic retrograde cholangiopancreatography, as well as longer operation and length of stay.

scholarly journals Bile Duct Injuries Following Laparoscopic Cholecystectomy

2018 ◽  
Vol 15 (1) ◽  
pp. 14-19
Author(s):  
Mohammad Ibrahim Khalil ◽  
Haridas Saha ◽  
Azmal Kader Chowdhury ◽  
Imarat Hossain ◽  
AZM Mostaque Hossain
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Open Cholecystectomy ◽  
Standard Procedure ◽  
Gall Stone ◽  
Common Bile Duct Injury ◽  
Medical College ◽  
Bile Duct Injuries ◽  
Case Files

Background: Laparoscopic cholecystectomy (LC) is the gold standard procedure for the gall stone diseases.Objective: This study aimed to assess the outcome of laparoscopic cholecystectomy (LC) by determining the frequency of complications especially of bile duct injuries.Methodology: This retrospective study was conducted in the Department of surgery at Dhaka Medical College and Hospital, Dhaka, Bangladesh. The case files of all patients undergoing laparoscopic cholecystectomy (LC) from the year of 2013 to 2015 were retrospectively analyzed. The data were collected according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open surgery.Results: During the three years a total number of 336 patients were underwent LC for chronic cholecystitis (CC) of which 22(6.5%) developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%); other 43(12.8%) patients had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC.Conclusion: The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.Journal of Science Foundation 2017;15(1):14-19

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