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Endoscopic Management of Bile Duct Injury During Laparoscopic Cholecystectomy

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Management of Benign Biliary Stenosis and Injury

Abstract

With the advent of laparoscopic cholecystectomy the incidence of iatrogenic lesions of the biliary tree have raised to up to three times. In the past, surgical repair was the treatment of choice of bile duct injuries, while today endoscopic retrograde cholangio-pancreatography is the first-line treatment for the majority of these injuries. Early bile duct injuries present within 1 week from surgery, and represent about 10 % of all post-cholecystectomy injuries. The vast majority of bile duct injuries become symptomatic after weeks or months after surgery, when the injury has evolved into a stricture. Endoscopic management of bile duct injuries varies on the basis of the type of injury, the presence or not of biliary leakage and/or bile duct stones, and the time of onset, whereas management of strictures is mostly dependent on their complexity. At present, sole biliary sphincterotomy with or without stones extraction and/or stent placement is the treatment of choice for the majority of bile leaks. The treatment of choice for bile duct strictures is plastic multistenting with every 3-month stent exchange during a period of 1 year.

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References

  1. Stewart L. Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 2014;94:297–310.

    Article  PubMed  Google Scholar 

  2. Archer SB, Brown DW, Smith CD, Branum GD, Hunter JG. Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Ann Surg. 2001;234:549–58.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Nuzzo G, Giuliante F, Giovannini I, Ardito F, D'Acapito F, Vellone M, Murazio M, Capelli G. Bile duct injury during laparoscopic cholecystectomy: results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005;140:986–92.

    Article  PubMed  Google Scholar 

  4. Jakobs R, Riemann JF. The role of endoscopy in acute recurrent and chronic pancreatitis and pancreatic cancer. Gastroenterol Clin North Am. 1999;28:783–800. xii.

    Article  PubMed  CAS  Google Scholar 

  5. Georgiades CP, Mavromatis TN, Kourlaba GC, Kapiris SA, Bairamides EG, Spyrou AM, Kokkinos CN, Spyratou CS, Ieronymou MI, Diamantopoulos GI. Is inflammation a significant predictor of bile duct injury during laparoscopic cholecystectomy? Surg Endosc. 2008;22:1959–64.

    Article  PubMed  Google Scholar 

  6. Nuzzo G, Giuliante F, Persiani R. The risk of biliary ductal injury during laparoscopic cholecystectomy. J Chir (Paris). 2004;141:343–53.

    Article  CAS  Google Scholar 

  7. Vallon AG, Mason RR, Laurence BH, Cotton PB. Endoscopic retrograde cholangiography in post-operative bile duct strictures. Br J Radiol. 1982;55:32–5.

    Article  PubMed  CAS  Google Scholar 

  8. Bergman JJ, van den Brink GR, Rauws EA, de Wit L, Obertop H, Huibregtse K, Tytgat GN, Gouma DJ. Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut. 1996;38:141–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Costamagna G, Shah S, Shimpi L. Benign biliary strictures. In: Saunders, ed. ERCP. 1 ed. 2008:327–33.

    Google Scholar 

  10. Pitt HA, Miyamoto T, Parapatis SK, Tompkins RK, Longmire Jr WP. Factors influencing outcome in patients with postoperative biliary strictures. Am J Surg. 1982;144:14–21.

    Article  PubMed  CAS  Google Scholar 

  11. Warshaw AL, Schapiro RH, Ferrucci Jr JT, Galdabini JJ. Persistent obstructive jaundice, cholangitis, and biliary cirrhosis due to common bile duct stenosis in chronic pancreatitis. Gastroenterology. 1976;70:562–7.

    PubMed  CAS  Google Scholar 

  12. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25:1241–4.

    Article  PubMed  CAS  Google Scholar 

  13. Bismuth H. Postoperative strictures of the bile duct. In: Churchill L, editor. The biliary tract. New York, NY: Blumgart, LH; 1982. p. 209–18.

    Google Scholar 

  14. Khalid TR, Casillas VJ, Montalvo BM, Centeno R, Levi JU. Using MR cholangiopancreatography to evaluate iatrogenic bile duct injury. AJR Am J Roentgenol. 2001;177:1347–52.

    Article  PubMed  CAS  Google Scholar 

  15. Pioche M, Ponchon T. Management of bile duct leaks. J Visc Surg. 2013;150:S33–8.

    Article  PubMed  CAS  Google Scholar 

  16. Richardson MC, Bell G, Fullarton GM. Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. Br J Surg. 1996;83:1356–60.

    Article  PubMed  CAS  Google Scholar 

  17. Schnelldorfer T, Sarr MG, Adams DB. What is the duct of Luschka?--A systematic review. J Gastrointest Surg. 2012;16:656–62.

    Article  PubMed  Google Scholar 

  18. Spanos CP, Syrakos T. Bile leaks from the duct of Luschka (subvesical duct): a review. Langenbecks Arch Surg. 2006;391:441–7.

    Article  PubMed  Google Scholar 

  19. Balija M, Huis M, Szerda F, Bubnjar J, Stulhofer M. Laparoscopic cholecystectomy--accessory bile ducts. Acta Med Croatica. 2003;57:105–9.

    PubMed  Google Scholar 

  20. Dumonceau JM, Tringali A, Blero D, Deviere J, Laugiers R, Heresbach D, Costamagna G. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2012;44:277–98.

    Article  PubMed  Google Scholar 

  21. Draganov P, Hoffman B, Marsh W, Cotton P, Cunningham J. Long-term outcome in patients with benign biliary strictures treated endoscopically with multiple stents. Gastrointest Endosc. 2002;55:680–6.

    Article  PubMed  Google Scholar 

  22. Smith MT, Sherman S, Lehman GA. Endoscopic management of benign strictures of the biliary tree. Endoscopy. 1995;27:253–66.

    Article  PubMed  CAS  Google Scholar 

  23. Foutch PG, Sivak Jr MV. Therapeutic endoscopic balloon dilatation of the extrahepatic biliary ducts. Am J Gastroenterol. 1985;80:575–80.

    PubMed  CAS  Google Scholar 

  24. Itoi T, Kasuya K, Abe Y, Isayama H. Endoscopic placement of a new short-term biodegradable pancreatic and biliary stent in an animal model: a preliminary feasibility study (with videos). J Hepatobiliary Pancreat Sci. 2011;18:463–7.

    Article  PubMed  Google Scholar 

  25. van Boeckel PG, Vleggaar FP, Siersema PD. Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review. BMC Gastroenterol. 2009;9:96.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Costamagna G, Tringali A, Mutignani M, Perri V, Spada C, Pandolfi M, Galasso D. Endotherapy of postoperative biliary strictures with multiple stents: results after more than 10 years of follow-up. Gastrointest Endosc. 2010;72:551–7.

    Article  PubMed  Google Scholar 

  27. Bergman JJ, Burgemeister L, Bruno MJ, Rauws EA, Gouma DJ, Tytgat GN, Huibregtse K. Long-term follow-up after biliary stent placement for postoperative bile duct stenosis. Gastrointest Endosc. 2001;54:154–61.

    Article  PubMed  CAS  Google Scholar 

  28. Davids PH, Groen AK, Rauws EA, Tytgat GN, Huibregtse K. Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet. 1992;340:1488–92.

    Article  PubMed  CAS  Google Scholar 

  29. Deviere J, Cremer M, Baize M, Love J, Sugai B, Vandermeeren A. Management of common bile duct stricture caused by chronic pancreatitis with metal mesh self expandable stents. Gut. 1994;35:122–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Walter D, Laleman W, Jansen JM, van Milligen de Wit AW, Weusten BL, van Boeckel PG, Hirdes MM, Vleggaar FP, Siersema PD. A fully covered self-expandable metal stent with antimigration features for benign biliary strictures: a prospective, multicenter cohort study. Gastrointest Endosc. 2015.

    Google Scholar 

  31. Perri V, Boskoski I, Tringali A, Familiari P, Mutignani M, Marmo R, Costamagna G. Fully covered self-expandable metal stents in biliary strictures caused by chronic pancreatitis not responding to plastic stenting: a prospective study with 2 years of follow-up. Gastrointest Endosc. 2012;75:1271–7.

    Article  PubMed  Google Scholar 

  32. Baron TH, Poterucha JJ. Insertion and removal of covered expandable metal stents for closure of complex biliary leaks. Clin Gastroenterol Hepatol. 2006;4:381–6.

    Article  PubMed  Google Scholar 

  33. Tocchi A, Mazzoni G, Liotta G, Costa G, Lepre L, Miccini M, De ME, Lamazza MA, Fiori E. Management of benign biliary strictures: biliary enteric anastomosis vs endoscopic stenting. Arch Surg. 2000;135:153–7.

    Article  PubMed  CAS  Google Scholar 

  34. Tuvignon N, Liguory C, Ponchon T, Meduri B, Fritsch J, Sahel J, Boyer J, Legoux JL, Escourrou J, Boustiere C, Arpurt JP, Barthet M, Tuvignon P, Bommelaer G, Ducot B, Prat F. Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study. Endoscopy. 2011;43:208–16.

    Article  PubMed  CAS  Google Scholar 

  35. de Reuver PR, Rauws EA, Vermeulen M, Dijkgraaf MG, Gouma DJ, Bruno MJ. Endoscopic treatment of post-surgical bile duct injuries: long term outcome and predictors of success. Gut. 2007;56:1599–605.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Canena J, Liberato M, Coutinho AP, Marques I, Romao C, Veiga PM, Neves BC. Predictive value of cholangioscopy after endoscopic management of early postcholecystectomy bile duct strictures with an increasing number of plastic stents: a prospective study (with videos). Gastrointest Endosc. 2014;79:279–88.

    Article  PubMed  Google Scholar 

  37. Kahaleh M, Behm B, Clarke BW, Brock A, Shami VM, De La Rue SA, Sundaram V, Tokar J, Adams RB, Yeaton P. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? (with video). Gastrointest Endosc. 2008;67:446–54.

    Article  PubMed  Google Scholar 

  38. Mahajan A, Ho H, Sauer B, Phillips MS, Shami VM, Ellen K, Rehan M, Schmitt TM, Kahaleh M. Temporary placement of fully covered self-expandable metal stents in benign biliary strictures: midterm evaluation (with video). Gastrointest Endosc. 2009;70:303–9.

    Article  PubMed  Google Scholar 

  39. Garcia-Cano J, Taberna-Arana L, Jimeno-Ayllon C, Martinez-Fernandez R, Serrano-Sanchez L, Reyes-Guevara AK, Vinuelas-Chicano M, Gomez-Ruiz CJ, Morillas-Arino MJ, Perez-Garcia JI, Perez-Vigara G, Perez-Sola A. Use of fully covered self-expanding metal stents for the management of benign biliary conditions. Rev Esp Enferm Dig. 2010;102:526–32.

    PubMed  CAS  Google Scholar 

  40. Lalezari D, Singh I, Reicher S, Eysselein VE. Evaluation of fully covered self-expanding metal stents in benign biliary strictures and bile leaks. World J Gastrointest Endosc. 2013;5:332–9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Park do H, Lee SS, Lee TH, Ryu CH, Kim HJ, Seo DW, Park SH, Lee SK, Kim MH, Kim SJ. Anchoring flap versus flared end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study (with videos). Gastrointest Endosc. 2011;73:64–70.

    Article  PubMed  Google Scholar 

  42. Kahaleh M, Brijbassie A, Sethi A, Degaetani M, Poneros JM, Loren DE, Kowalski TE, Sejpal DV, Patel S, Rosenkranz L, McNamara KN, Raijman I, Talreja JP, Gaidhane M, Sauer BG, Stevens PD. Multicenter trial evaluating the use of covered self-expanding metal stents in benign biliary strictures: time to revisit our therapeutic options? J Clin Gastroenterol. 2013;47:695–9.

    Article  PubMed  CAS  Google Scholar 

  43. Irani S, Baron TH, Akbar A, Lin OS, Gluck M, Gan I, Ross AS, Petersen BT, Topazian M, Kozarek RA. Endoscopic treatment of benign biliary strictures using covered self-expandable metal stents (CSEMS). Dig Dis Sci. 2014;59:152–60.

    Article  PubMed  CAS  Google Scholar 

  44. Kassab C, Prat F, Liguory C, Meduri B, Ducot B, Fritsch J, Choury AD, Pelletier G. Endoscopic management of post-laparoscopic cholecystectomy biliary strictures. Long-term outcome in a multicenter study. Gastroenterol Clin Biol. 2006;30:124–9.

    Article  PubMed  Google Scholar 

  45. Kuzela L, Oltman M, Sutka J, Hrcka R, Novotna T, Vavrecka A. Prospective follow-up of patients with bile duct strictures secondary to laparoscopic cholecystectomy, treated endoscopically with multiple stents. Hepatogastroenterology. 2005;52:1357–61.

    PubMed  Google Scholar 

  46. Vitale GC, Tran TC, Davis BR, Vitale M, Vitale D, Larson G. Endoscopic management of postcholecystectomy bile duct strictures. J Am Coll Surg. 2008;206:918–23.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Digestive Endoscopy Unit, Catholic University of Rome, Rome, Italy

    Guido Costamagna M.D., F.A.C.G. & Ivo Boškoski M.D., Ph.D.

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  1. Guido Costamagna M.D., F.A.C.G.
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  2. Ivo Boškoski M.D., Ph.D.
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Correspondence to Ivo Boškoski M.D., Ph.D. .

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Editors and Affiliations

  1. Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada

    Elijah Dixon

  2. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Charles M. Vollmer Jr.

  3. Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada

    Gary R. May

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Costamagna, G., Boškoski, I. (2015). Endoscopic Management of Bile Duct Injury During Laparoscopic Cholecystectomy. In: Dixon, E., Vollmer Jr., C., May, G. (eds) Management of Benign Biliary Stenosis and Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-22273-8_26

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  • DOI: https://doi.org/10.1007/978-3-319-22273-8_26

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22272-1

  • Online ISBN: 978-3-319-22273-8

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