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Role of laparoscopy in the immediate, intermediate, and long-term management of iatrogenic bile duct injuries during laparoscopic cholecystectomy

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Abstract

Purpose

Bile duct injuries (BDI) during a laparoscopic cholecystectomy still remain as one of the most feared complications in surgery. The use of laparoscopy for its management is a controversial subject of discussion. The purpose of this study is to assess the amount of possibilities that a laparoscopic approach allows in its resolution.

Methods

A retrospective analysis of all the patients diagnosed with BDI at our center was carried out. The analysis was made considering three different scenarios in which laparoscopy can be used: (1) intraoperative management of BDI; (2) postoperative management of bile peritonitis; (3) deferred treatment of BDI.

Results

We analyzed 22 patients in total who were divided into three groups according to the different scenarios proposed. In the first group, the applicability of laparoscopy was 45%, some complications occurred in two patients, and primary patency was obtained in seven. In the second group, four of them presented a grade III complication. In the third group, the applicability of laparoscopy was 13.6%. Only one patient presented a IIIa complication and primary patency was obtained in all of them.

Conclusions

Laparoscopy plays a more important role in BDI management every day. This approach, in selected cases, is associated with good long-term results and perioperative advantages of a minimally invasive approach.

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Data Availability

All data are available in a de-identified way to protect confidentiality.

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Acknowledgements

To Miss Karlijn Schouten and Miss Maria Victoria Perez for their technical assistance

Funding

Funding has been provided by the general surgery department of Hospital Italiano de Buenos Aires.

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Authors and Affiliations

  1. General Surgery Service Hospital Italiano de Buenos Aires, Pres. Tte. Gral, Juan Domingo Perón 4190, C 1199, Buenos Aires, Argentina

    Drago Julian & Pekolj Juan

  2. Hepato-Pancreatic-Biliary (HPB) Surgery Section Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    de Santibañes Martín, Sánchez Clariá Rodrigo & Mazza Oscar

  3. HPB Surgery Section Hospital Italiano de San Justo, Buenos Aires, Argentina

    Palavecino Martín

  4. General Surgery Service Hospital Italiano de San Justo, Buenos Aires, Argentina

    Arbues Guillermo

Authors
  1. Drago Julian
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  2. de Santibañes Martín
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  3. Palavecino Martín
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  4. Sánchez Clariá Rodrigo
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  5. Arbues Guillermo
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  6. Mazza Oscar
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  7. Pekolj Juan
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Contributions

Study conception and design: Drago Julian, Palavecino Martín, de Santibañes Martín, Sánchez Clariá Rodrigo, Arbues Guillermo, Mazza Oscar, Pekolj Juan. Acquisition of data: Drago Julian, Palavecino Martín, de Santibañes Martín, Sánchez Clariá Rodrigo, Arbues Guillermo, Mazza Oscar, Pekolj Juan. Analysis and interpretation of data: Drago Julian, Palavecino Martín,de Santibañes Martín, Sánchez Clariá Rodrigo, Arbues Guillermo, Mazza Oscar, Pekolj Juan. Drafting of manuscript: Drago Julian, de Santibañes Martín, Pekolj Juan. Critical revision of manuscript: Drago Julian, Palavecino Martín, de Santibañes Martín,Sánchez Clariá Rodrigo, Arbues Guillermo, Mazza Oscar, Pekolj Juan.

Corresponding author

Correspondence to Drago Julian.

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Conflict of interest

The authors declare no competing interests.

Ethics approval

Ethics approval was obtained from the Hospital Italiano de Buenos Aires (HIBA) Research Ethics Committee, protocol number 2778.

Consent to participate

No specific written consent was required as the protocol is of minimum risk and fulfills the requirements expressed at CIOMS guidelines 2019.

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Julian, D., Martín, d.S., Martín, P. et al. Role of laparoscopy in the immediate, intermediate, and long-term management of iatrogenic bile duct injuries during laparoscopic cholecystectomy. Langenbecks Arch Surg 407, 663–673 (2022). https://doi.org/10.1007/s00423-022-02452-5

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