Skip to main content
SpringerLink
Log in

Avoiding biliary injury during laparoscopic cholecystectomy: technical considerations

  • Biliary Tract Forum
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Experience alone is not sufficient to protect surgeons and their patients from biliary injury. This article suggests valuable technical considerations for the performance of laparoscopic cholecystectomy. Against the background of a widely accepted biliary injury classification system, the risk factors and causes of biliary injury are considered. The concept of the critical view exposure technique for Calot’s triangle is emphasized from the practical standpoint of avoiding misidentified injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Strasberg SM, Hertl M, Soper NJ (1995) An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 180: 101–125

    PubMed  CAS  Google Scholar 

  2. Hugh TB (2002) Laparoscopic bile duct injury: some myths (review, see comment, 21 references). ANZ J Surg 72: 164–167

    Article  PubMed  Google Scholar 

  3. Adamsen S, Hansen OH, Funch-Jensen P, et al. (1997) Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series. J Am Coll Surg 184: 571–578

    PubMed  CAS  Google Scholar 

  4. Murr MM, Gigot JF, Nagorney DM, et al. (1999) Long-term results of biliary reconstruction after laparoscopic bile duct injuries. Arch Surg 134: 604–609

    Article  PubMed  CAS  Google Scholar 

  5. Doganay M, Kama NA, Reis E, et al. (2002) Management of main bile duct injuries that occur during laparoscopic cholecystectomy. Surg Endosc 16: 216

    Article  PubMed  CAS  Google Scholar 

  6. Gazzaniga GM, Filauro M, Mori L (1254) Surgical treatment of iatrogenic lesions of the proximal common bile duct. World J Surg 25: 1254–1259

    Article  PubMed  CAS  Google Scholar 

  7. Mercado MA, Chan C, Orozco H, et al. (1351) Acute bile duct injury: the need for a high repair. Surg Endosc 17: 1351–1355

    Article  PubMed  CAS  Google Scholar 

  8. Sikora SS, Kumar A, Das NR, et al. (2001) Laparoscopic bile duct injuries: spectrum at a tertiary care center. J Laparoendosc Adv Surg Tech Part A 11: 63–68

    Article  CAS  Google Scholar 

  9. Reid SH, Cho SR, Shaw CI, Turner MA (1986) Anomalous hepatic duct inserting into the cystic duct. AJR Am J Roentgenol 147: 1181–1182

    PubMed  CAS  Google Scholar 

  10. Davidoff AM, Pappas TN, Murray EA, et al. (1992) Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg 215: 196–202

    Article  PubMed  CAS  Google Scholar 

  11. Meyers WC, et al. (1991) A prospective analysis of 1,518 laparoscopic cholecystectomies. The Southern Surgeons Club. New Engl J Med 324: 1073–1078

    Article  Google Scholar 

  12. Berry SM, Ose KJ, Bell RH, Fink AS (1994) Thermal injury of the posterior duodenum during laparoscopic cholecystectomy. Surg Endosc 8: 197–200

    Article  PubMed  CAS  Google Scholar 

  13. Schol FP, Go PM, Gouma DJ (1994) Risk factors for bile duct injury in laparoscopic cholecystectomy: analysis of 49 cases (see comments). Br J Surg 81: 1786–1788

    PubMed  CAS  Google Scholar 

  14. Russell JC, Walsh SJ, Mattie AS, Lynch JT (1996) Bile duct injuries, 1989–1993: a statewide experience. Connecticut Laparoscopic Cholecystectomy Registry. Arch Surg 131: 382–388

    PubMed  CAS  Google Scholar 

  15. Kum CK, Eypasch E, Lefering R, et al. (1996) Laparoscopic cholecystectomy for acute cholecystitis: is it really safe? World J Surg 20: 43–48

    Article  PubMed  CAS  Google Scholar 

  16. Strasberg SM, Eagon CJ, Drebin JA (2000) The “hidden cystic duct” syndrome and the infundibular technique of laparoscopic cholecystectomy: the danger of the false infundibulum. J Am Coll Surg 191: 661–667

    Article  PubMed  CAS  Google Scholar 

  17. Hugh TB (2002) New strategies to prevent laparoscopic bile duct injury: surgeons can learn from pilots. Surgery 132: 826–835

    Article  PubMed  Google Scholar 

  18. Way LW, Stewart L, Gantert W, et al. (2003) Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 237: 460–469

    Article  PubMed  Google Scholar 

  19. Alves A, Farges O, Nicolet J, et al. (2003) Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct strictures. Ann Surg 238: 93–96

    Article  PubMed  Google Scholar 

  20. Ferguson CM, Rattner DW, Warshaw AL (1992) Bile duct injury in laparoscopic cholecystectomy. Surg Laparosc Endoscoc Percut Tech 2: 1–7

    CAS  Google Scholar 

  21. Fletcher DR, Hobbs MS, Tan P, et al. (1999) Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. Ann Surg 229: 449–457

    Article  PubMed  CAS  Google Scholar 

  22. Flum DR, Dellinger EP, Cheadle A, et al. (2003) Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. JAMA 289: 1639–1644

    Article  PubMed  Google Scholar 

  23. Ludwig K, Bernhardt J, Steffen H, Lorenz D (2002) Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy. Surg Endosc 16: 1098–1104

    Article  PubMed  CAS  Google Scholar 

  24. Carroll BJ, Friedman RL, Liberman MA, Phillips EH (1996) Routine cholangiography reduces sequelae of common bile duct injuries. Surg Endosc 10: 1194–1197

    Article  PubMed  CAS  Google Scholar 

  25. Kullman E, Borch K, Lindstrom E, et al. (1996) Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injuries during laparoscopic cholecystectomy. Br J Surg 83: 171–175

    Article  PubMed  CAS  Google Scholar 

  26. Woods MS, Traverso LW, Kozarek RA, et al. (1995) Biliary tract complications of laparoscopic cholecystectomy are detected more frequently with routine intraoperative cholangiography. Surg Endosc 9: 1076–1080

    Article  PubMed  CAS  Google Scholar 

  27. Park YH, Oskanian Z (1992) Obstructive jaundice after laparoscopic cholecystectomy with electrocautery. Am Surg 58: 321–323

    PubMed  CAS  Google Scholar 

  28. Carroll BJ, Birth M, Phillips EH (1998) Common bile duct injuries during laparoscopic cholecystectomy that result in litigation. Surg Endosc 12: 310–313

    Article  PubMed  CAS  Google Scholar 

  29. Gigot J, Etienne J, Aerts R, et al. (1997) The dramatic reality of biliary tract injury during laparoscopic cholecystectomy: an anonymous multicenter Belgian survey of 65 patients. Surg Endosc 11: 1171–1178

    Article  PubMed  CAS  Google Scholar 

  30. Stewart L, Way LW (1995) Bile duct injuries during laparoscopic cholecystectomy: factors that influence the results of treatment. Arch Surg 1995: 1123–1129

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Surgery, Harvard Medical School, Stoneman 928, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA

    M. P. Callery

Authors
  1. M. P. Callery
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. P. Callery.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Callery, M.P. Avoiding biliary injury during laparoscopic cholecystectomy: technical considerations. Surg Endosc 20, 1654–1658 (2006). https://doi.org/10.1007/s00464-006-0488-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-006-0488-3

Keywords

Search

Navigation