scholarly journals Bile leakage from subvesical bile duct (duct of Luschka) after laparoscopic cholecystectomy

2021 ◽  
Vol 25 (1) ◽  
pp. S329-S329
Author(s):  
Young-Min KIM ◽  
Gun-Hyung NA ◽  
Il-Young PARK
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Leakage ◽  
Duct Of Luschka

scholarly journals The subvesical duct of Luschka: A source of bile leakage following gallbladder removal

2003 ◽  
Vol 7 (2) ◽  
pp. 44-46
Author(s):  
Ian C. Duncan ◽  
Basil J. Sher
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Hepatic Duct ◽  
Bile Leakage ◽  
Duct Obstruction ◽  
Duct Ligation ◽  
Duct Of Luschka ◽  
Gallbladder Fossa ◽  
Bile Leaks ◽  
Gallbladder Removal

We describe a case of bile leakage following laparoscopic cholecystectomy further complicated by iatrogenic central bile duct obstruction. The site of leakage was identified not from the site of the inadvertent proper hepatic duct ligation but from a damaged aberrant subvesical duct communicating with the gallbladder fossa. The anatomy of these subvesical ducts is explained as is their surgical importance with relation to the aetiology of bile leaks after cholecystectomy.

Bile Duct Injuries during Laparoscopic Cholecystectomy: Management and Outcome

2005 ◽  
Vol 71 (12) ◽  
pp. 1060-1065 ◽  
Author(s):  
Kostas Tsalis ◽  
Emmanouil Zacharakis ◽  
Konstantinos Vasiliadis ◽  
Stavros Kalfadis ◽  
Orestis Vergos ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Definitive Treatment ◽  
Biliary Disease ◽  
Adequate Treatment ◽  
Bile Duct Injuries ◽  
Duct Ligation ◽  
Duct Of Luschka ◽  
Minor Injuries

The aim of this study is to analyze our experience with the management of bile duct injuries (BDIs) following laparoscopic cholecystectomy (LC). From 1996 to 2004, 21 patients with BDI after LC were treated in our department. The BDIs were graded according to the classification of Strasberg. Ten patients had minor BDI. Minor injuries were classified as A in six and D in four patients. In three patients, endoscopic retrograde cholangiopancreatography sphincterotomy and stent placement was adequate treatment. Six patients required laparotomy and bile duct ligation or suturing, and one patient underwent laparoscopy with additional ligation of a duct of Luschka. Eleven patients had major BDIs. These injuries were classified as E1 in two, E2 in three, E3 in four, and E4 in two patients. Among the patients with a major BDI, Roux- en-Y hepaticojejunostomy was performed. After a median follow-up of 69.45 months, no evidence of biliary disease has been detected among our patients. BDIs should be managed in a specialist unit where surgeons skilled to perform such repairs should undertake definitive treatment. Roux- en-Y hepaticojejunostomy is the procedure of choice in the management of major BDIs as it is accompanied by satisfactory results.

scholarly journals Results of surgical treatment of extrahepatic bile duct injuries

2020 ◽  
Vol 37 (1) ◽  
pp. 63-72
Author(s):  
L. P. Kotelnikova ◽  
I. G. Burnyshev ◽  
O. V. Bazhenova ◽  
D. V. Trushnikov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Bile Duct ◽  
Bile Ducts ◽  
Bile Leakage ◽  
Biliary Reconstruction ◽  
Long Term Outcomes ◽  
Endoscopic Retrograde ◽  
Extrahepatic Bile Ducts

Aim. To evaluate the short-and long-term outcomes after surgical repair of iatrogenic lesions of extrahepatic bile ducts depending on the timing of diagnosis in conditions of specialized clinic. Materials and methods. Our study involved a retrospective analysis of 159 patients who were treated for iatrogenic lesions of extrahepatic bile ducts during 1987-2017. These patients were divided into two groups depending on the timing of surgical treatments: early biliary reconstruction ( 5 days after bile duct transection) and late biliary reconstruction ( 5 days post-transection). These groups were compared on the basis of postoperative morbidity and long-term outcomes. Results. Following laparoscopic cholecystectomy, 2 patients received endoscopic retrograde stents due to bile leakage from the cystic ducts, and 14 patients underwent hepaticocholedochostomy using Ker drainage. The incidence of bile leakage was observed in 14. 3 % of cases during the early post-operative period, strictures appeared in 28.6 % of cases. Hepaticojejunostomy was performed in 91 cases: in 62 with stents and in 29 without stents. Bile leakage was observed in 17.6 % of cases, and strictures in 19.8 % of cases. Our statistical analyses revealed no significant differences between the two groups (i.e., early and late timing of surgical treatment) in the rates of bile leakage and strictures. The extent of surgeons experience in bile surgery significantly correlated with positive outcomes. Conclusions. Endoscopic retrograde stent proved to be an effective and fast solution in cases of bile leakage from cystic ducts following laparoscopic cholecystectomy. Although it is preferable to perform reconstructive surgeries within the first five days after bile duct injury, our results indicated that in the presence of external bile fistula without peritonitis and severe cholangitis, reconstructive surgery can be performed in specialized surgical departments later than 5 days with satisfactory results.

DAMAGE TO THE BILE DUCTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY. REVIEW.

2021 ◽  
pp. 17-25
Author(s):  
Maxat Doskhanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Treatment And Prevention ◽  
Technical Errors ◽  
Bile Duct Injuries ◽  
Good Cosmetic

This article provides a review of the literature on bile duct injuries after laparoscopic cholecystectomy. Laparascopy is considered the gold standard in the treatment of gallstone disease. This technique has a number of positive advantages: minimally invasiveness, quick rehabilitation, a shorter hospital stay, a good cosmetic effect, and a low lethal outcome. Along with these advantages, the number of complications also increased: damage to the bile ducts, hepatic vessels, bile leakage, formation of strictures, defects in drainage of the biliary tract and improper treatment of the cystic duct, insufficient drainage of the abdominal cavity. Today, many aspects of surgical treatment and prevention of bile duct injuries remain controversial and are still considered relevant. The main reasons for this complication are: lack of experience of the surgeon, inattention, ignorance of the main options and possible anomalies of important anatomical structures in the area of the hepatic hilum and hepato-duodenal ligament, technical errors.

Management of B ile Duct Injury after Laparoscopic Cholecystectomy

2018 ◽  
Vol 30 (2) ◽  
pp. 95-97
Author(s):  
Md Rafiqul Islam ◽  
Md Showkat Ali ◽  
SM Golam Azam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Early Diagnosis ◽  
Bile Duct Injury ◽  
Bile Leakage ◽  
Early Referral ◽  
Life Threatening ◽  
The Common ◽  
Injury Control ◽  
Level Hospital

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

scholarly journals ASSESSMENT OF RISK FACTORS AND COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 1 (1) ◽  
pp. 08-10
Author(s):  
Maram A. Fagiri ◽  
Turgut İmir Başak ◽  
Serap Nergiz
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Surgical Procedures ◽  
Bile Leakage ◽  
Developed Countries ◽  
Intraoperative Bleeding ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Common Etiology ◽  
The Difference

Cholecystectomy is one of the most common abdominal surgical procedures in developed countries. 74 patients of cholecystectomy of both genders were enrolled. was recorded. A thorough clinical examination was done. Lipid profile, Etiology and complications were recorded. Common etiology found to be cholestasis in 38, hyperlipidemia in 24, hereditary spherocystosis and idiopathic cases. The difference was significant (P< 0.05). Complications were intraoperative bleeding, biliary peritonitis, intra-abdominal collections bile duct injury, ligation of CBD, bile leakage, SSI, and retained CBD stones cases. The difference was significant (P< 0.05). Authors found that common etiology found to be cholestasis, hyperlipidemia, hereditary spherocystosis and idiopathic.

scholarly journals Bile leak syndrome after laparoscopic cholecystectomy

2019 ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Minimally Invasive ◽  
Abdominal Cavity ◽  
Bile Leak ◽  
Bile Leakage ◽  
Early Postoperative Period ◽  
Type I

Aim of the study was the assasement of surgical treatment results of patients with cholelithiasis, who had external or internal bile leakage (BL), for the optimization and improvement of diagnostic programme and surgical tactic of minimally invasive techniques usage. Materials and methods. Results of surgical treatment during the early postoperative period of patients with cholelithiasis, who underwent laparoscopic cholecystectomy (LC) were analysed. Results. In early post-operative period 67 (0,6%) patients, mean aged 56,9 ± 7,4 had BL. 54 (81,0%) of them were women, 13 (19,0%) were men. 21 (31,3%) patients underwent LC due to chronic cholecystitis, 46 (68,7%) patients had acute cholecystitis. In 54 (81,0%) cases there was drainage bile leakage, in 13 (19,0%) cases bile collection in abdominal cavity was identified several days after drains ejection, due to clinical manifestation and ultrasonography data. 23 (34,3%) patients were treated conservatively. Minimally invasive endoscopic manipulations, ultrasonography controlled percutaneous drainage and relaparotomy were effective in 35 (52,2%) patients, 9 (13,4%) patients underwent laparotomy with following surgical correction of BL. These patients had dense perivesical infiltrates, Mirizzi’s syndrome type I. 6 (9,0%) patients underwent laparotomy, abdominal cavity sanation and drainage. In 1 (1,5%) case partial right bile duct injury was identified, defect suturing and Vishnevsky common bile duct drainage. In 2 (3,0%) cases the cause of BL was more than 2/3 diameter injury of common bile duct. These patients underwent Roux-en-Y hepaticojejunostomy. Conclusion. Installation of drainage into the hepatic space and the right flank provide early diagnosis of postoperative complications, one of which is bile flow syndrome. Ultrasound examination of abdominal organs and endoscopic retrograde cholangiopancretography are performed to determine the cause and localization of the syndrome of the BL syndrome, depending on the volume of the BL. Repeated laparoscopy is indicated for the phenomena of bile peritonitis, significant accumulation of bile in the abdominal cavity. The complex usage of relaparoscopy, transduodenal endoscopic interventions and puncture techniques can significantly reduce the number of laparotomy operations to correct complications.

scholarly journals Reinterventions following laparoscopic cholecystectomy and bile duct exploration. A review of prospective data from 5740 patients

2021 ◽  
Author(s):  
Hwei Jene Ng ◽  
Ahmad H. M. Nassar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Perioperative Complications ◽  
Bile Leakage ◽  
Common Bile Duct Exploration ◽  
Index Admission ◽  
Biliary Surgery ◽  
Open Conversion ◽  
High Workload ◽  
Low Incidence

Abstract Background Complications following laparoscopic cholecystectomy (LC) and common bile duct exploration (CBDE) for the management of gallstones or choledocholithiasis impact negatively on patients’ quality of life and may lead to reinterventions. This study aims to evaluate the causes and types of reintervention following index admission LC with or without CBDE. Methods A prospectively maintained database of LC and CBDE performed by a single surgeon was analysed. Preoperative factors, difficulty grading and perioperative complications requiring reintervention and readmissions were examined. Results Reinterventions were required in 112 of 5740 patients (2.0%), 89 (1.6%) being subsequent to complications. The reintervention cohort had a median age of 64 years, were more likely to be females (p < 0.0023) and to be emergency admissions (67.9%, p < 0.00001) with obstructive jaundice (35.7%, p < 0.00001). 46.4% of the reintervention cohort had a LC operative difficulty grade IV or V and 65.2% underwent a CBDE. Open conversion was predictive of the potential for reintervention (p < 0.00001). The most common single cause of reintervention was retained stones (0.5%) requiring ERCP followed by bile leakage (0.3%) requiring percutaneous drainage, ERCP and relaparoscopy. Relaparoscopy was necessary in 17 patients and open surgery in 13, 6 of whom not resulting from complications. There were 5 deaths. Conclusion This large series had a low incidence of reinterventions resulting from complications in spite of a high workload of index admission surgery for biliary emergencies and bile duct stones. Surgical or endoscopic reinterventions following LC alone occurred in only 0.8%. The most common form of reintervention was ERCP for retained CBD stones. This important outcome parameter of laparoscopic biliary surgery can be optimised through early diagnosis and timely reintervention for complications.

Bile duct injury and bile leakage in laparoscopic cholecystectomy

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