Abstract
Cholecystectomy is one of the most common general surgical operations performed worldwide. The risk of bile duct injury (BDI) during laparoscopic cholecystectomy is two to three times higher than during open cholecystectomy. The worldwide incidence of bile duct injury is 0.5% or 1 in 200 cases. BDI and its consequences result in significant morbidity and may even cause mortality; it also increases the cost of treatment and can be a common reason for medico-legal suits against the surgeons. To minimize the incidence of BDI and to manage it timely and appropriately, a set of guidelines was deemed necessary by a group of senior surgeons during a Society of Endoscopic and Laparoscopic Surgeons of India (SELSI) meeting in 2016. Guidelines for “Safe Laparoscopic Cholecystectomy” and bile duct injury management formulated by other international societies are already available. The applicability of these guidelines to Indian subjects, especially in small peripheral centers, was limited. Hence, a decision was taken to form a set of guidelines for general surgeons with basic laparoscopic skills with little or no advanced laparoscopic skills. Those working in a solo practice, nursing homes, and small private hospitals at talukas or districts should have “Safe Cholecystectomy” guidelines and management of BDI suitable to their situation. These guidelines were formed after three consensus meetings and have been approved by a SELSI Expert Group.
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Abbreviations
- AIDS:
-
Acquired immune deficiency syndrome
- ALP:
-
Alkaline phosphatase
- ASA:
-
American Society of Anesthesiologists
- BDI:
-
Bile duct injury
- BMI:
-
Body mass index
- CBD:
-
Common bile duct
- CECT:
-
Contrast enhanced computerized tomography
- CHA:
-
Chronic hemolytic anemia
- CHD:
-
Common hepatic duct
- COPD:
-
Chronic obstructive pulmonary disease
- CVS:
-
Critical view of safety
- DLC:
-
Delayed laparoscopic cholecystectomy
- EAES:
-
European Association of Endoscopic Surgeons
- EBF:
-
External biliary fistula
- ELC:
-
Early laparoscopic cholecystectomy
- ERCP:
-
Endoscopic retrograde cholangio-pancreatography
- ESE:
-
Endoscopic papillotomy and stone extraction
- FNAC:
-
Fine needle aspiration cytology
- GB:
-
Gallbladder
- HIDA:
-
Hepatobiliary iminodiacetic acid scan
- HIV:
-
Human immune deficiency virus
- IHBRD:
-
Intrahepatic biliary radical dilatation
- IOC:
-
Intraoperative cholangiogram
- IRCAD:
-
L’Institut de Recherchecontre les Cancers de l'AppareilDigestif
- KFT:
-
Kidney function test
- LC:
-
Laparoscopic cholecystectomy
- LCBDE:
-
Laparoscopic common bile duct exploration
- LFT:
-
Liver function test
- LMWH:
-
Low molecular weight heparin
- LOE:
-
Level of evidence
- MRC:
-
Magnetic resonance cholangiogram
- MRCP:
-
Magnetic resonance cholangio-pancreatography
- MS:
-
Mirizzi's syndrome
- OC:
-
Open cholecystectomy
- OHA:
-
Oral hypoglycemic agents
- SAGES:
-
Society of American Gastrointestinal and Endoscopic Surgeons
- SELSI:
-
Society of Endoscopic and Laparoscopic Surgeons of India
- SCD:
-
Sickle cell disease
- TLC:
-
Total leucocyte count
- WBC:
-
White blood cell
- USG:
-
Ultrasonography
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This consensus statement is for general guidance only; the recommendations made in this statement do not cover all situations and scenarios and may be modified depending upon the infrastructure and the expertise available in a given situation.
Note
The term common bile duct (CBD) has been used in these guidelines. At most places, it means and includes common hepatic duct (CHD) also.
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Bansal, V.K., Misra, M., Agarwal, A.K. et al. SELSI Consensus Statement for Safe Cholecystectomy — Prevention and Management of Bile Duct Injury — Part A. Indian J Surg 83 (Suppl 3), 592–610 (2021). https://doi.org/10.1007/s12262-019-01993-2
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DOI: https://doi.org/10.1007/s12262-019-01993-2