[Treatment of bile duct injuries during cholecystectomy]

Magy Seb. 2020 Jun;73(2):49-56. doi: 10.1556/1046.73.2020.2.1.
[Article in Hungarian]

Abstract

Biliary injury is a rare but a very serious complication of laparoscopic cholecystectomy (LC). Our aim was to analyse the incidence of the biliary injuries and its therapeutic outcome on patients who underwent LC or converted LC. Our research was conducted at the 1st Department of Surgery, Semmelweis University, Budapest between 2006 and 2016, retrospectively. We analysed the LCs and converted LCs performed at our Department and as well as cases where the primary operations were conducted at other institutions but they were unable to provide the adequate therapy for the injury, thus the patients were transferred to our institution. At the 1st Department of Surgery complications occurred in 0,66% (30/4885) of all LCs. 327 converted LCs were done, complications occurred in 26 (7.95%) times. 22 patients were transferred to the 1st Department of Surgery from other institutions. Bilio-vascular injuries occurred in 61% (41/78). ERCP was performed in 25 cases with a 92% success rate. Reoperation was needed in 41% (28/41). Biliary reconstruction during the reoperation was performed via hepaticojejunostomy in 82% of all reoperations. The therapeutic solutions of LC’s complications are complex. Therefore, the treatment is recommended only in institutions with appropriate experience.

Absztrakt: : A laparoszkópos cholecystectomia (LC) a leggyakrabban végzett műtétek egyike. A beavatkozás ritka, ugyanakkor nagyon súlyos szövődménye az epeúti sérülés. Célunk az LC, valamint laparoszkópos kezdés után konvertált műtétek során bekövetkezett epeúti sérülések és szövődményeik, valamint ezek ellátásának vizsgálata volt.

Keywords: bile duct injury; epeúti sérülés; laparoscopic cholecystectomy; laparoszkópos cholecystectomia; postoperative complications; posztoperatív szövődmények.

MeSH terms

  • Adult
  • Bile Ducts / injuries*
  • Biliary Tract / injuries*
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Cholecystectomy, Laparoscopic / statistics & numerical data
  • Cholelithiasis / epidemiology
  • Cholelithiasis / surgery*
  • Female
  • Humans
  • Incidence
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Reoperation / statistics & numerical data*
  • Retrospective Studies