Treatment of complex iatrogenic common hepatic duct injury following laparoscopic cholecystectomy

BMJ Case Rep. 2023 Dec 11;16(12):e254394. doi: 10.1136/bcr-2022-254394.

Abstract

We report the case of a woman in her 40s, with no significant medical history, submitted to a laparoscopic cholecystectomy in our institution for symptomatic gallbladder lithiasis. On postoperative day 4, she presented to our emergency room with severe abdominal pain and elevated inflammatory markers. Abdominal CT scan revealed a mass filled with liquid and air in the gallbladder fossa. Surgical exploration was performed revealing a major common hepatic duct iatrogenic injury, which was managed using suture over a T-tube. Three months after surgery, cholangiography showed a biliary stenosis, and a biodegradable stent was inserted through percutaneous transhepatic access. The difficulties in the management of this condition and its outcomes are discussed in this report.

Keywords: Gastroenterology; Gastrointestinal surgery; Interventional radiology; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cholangiography
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Female
  • Gallbladder
  • Hepatic Duct, Common / injuries
  • Hepatic Duct, Common / surgery
  • Humans
  • Iatrogenic Disease