Laparoscopic bile duct injuries: Management at a tertiary liver center

Savar, A., Carmody, I., Hiatt, J. R. and Busuttil, R. W. (2004). Laparoscopic bile duct injuries: Management at a tertiary liver center. In: Annual Meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara Ca, (906-909). 16-18 January 2004.

Author Savar, A.
Carmody, I.
Hiatt, J. R.
Busuttil, R. W.
Title of paper Laparoscopic bile duct injuries: Management at a tertiary liver center
Conference name Annual Meeting of the Southern California Chapter of the American College of Surgeons
Conference location Santa Barbara Ca
Conference dates 16-18 January 2004
Journal name American Surgeon   Check publisher's open access policy
Place of Publication Cumming, GA, United States
Publisher Southeastern Surgical Congress
Publication Year 2004
Sub-type Fully published paper
ISSN 0003-1348
1555-9823
Volume 70
Issue 10
Start page 906
End page 909
Total pages 4
Language eng
Abstract/Summary Bile duct injury is a rare but morbid complication of laparoscopic cholecystectomy (LC). This study was undertaken to evaluate the management of 20 patients with bile duct injuries during LC who were referred to a tertiary center with expertise in hepatobiliary surgery and liver transplantation. Sixteen (80%) were female. Mean age was 44 (range 13-70) years. Half of the injuries were distal (Bismuth I), and nearly half were diagnosed at LC. Reoperative repair was attempted in 30 per cent. Mean interval between injury and operation was 6.55 months (range 0 to 36 months). Eighteen patients underwent Roux-en-Y hepaticojejunostomy (HJ). Of the two patients who did not undergo HJ (both Bismuth I), one was treated with transhepatic cholangiography only, and one died of multiorgan failure. There were four minor complications and one late reoperation for stricture. We conclude that bile duct injury after LC is successfully managed in a tertiary center by a hepatobiliary-liver transplant team. Principles of management include anatomic definition of injury, control of sepsis, staged approach involving interventional radiology, and operative techniques refined in liver transplantation including magnification, fine sutures, selective use of internal stent, and liver biopsy.
Keyword Cholecystectomy
Experience
Strictures
Cholangiography
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Conference Paper
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Thu, 16 Jun 2011, 20:37:50 EST by System User on behalf of School of Medicine