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Treatment of the iatrogenic lesion of the biliary tree secondary to laparoscopic cholecystectomy: a single center experience

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Abstract

Surgical bile duct injury (SBDI), during laparoscopic cholecystectomy, is a worldwide ongoing problem. The purpose of this study is to analyze a single center retrospective experience with this topic. From 1999 to 2012, 30 patients with diagnosis of SBDI after laparoscopic cholecystectomy performed in other institute for gallbladder lithiasis and then transferred to our facility were enrolled in this analysis. We considered in the study the following parameters: classification and site of the bile duct injury, infective complications and therapeutic management according to early or late referral. Twenty four patients (80 %) had a SBDI type E1; a concomitant vascular injury was described in 3/30 (10 %) in right hepatic artery. 11 patients had HJJ as primary surgical treatment in our hospital. Surgical site infection was documented in 9/30 (30 %). The most common micro-organisms documented in SSI were E. coli with an incidence of 55.5 % of SSI. Worse infective complications were detected in the late referral group. Complex SBDI occurred during laparoscopic cholecystectomy should be early referred to advanced hepatobiliary program, for appropriate multidisciplinary management.

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References

  1. Ejaz A, Spolverato G, Kim Y, Dodson R, Sicklick JK, Pitt HA, Lillemoe KD, Cameron JL, Pawlik TM (2014) Long-term health-related quality of life after iatrogenic bile duct injury repair. J Am Coll Surg 219(5):923.e10–932.e10. doi:10.1016/j.jamcollsurg.2014.04.024

    Article  Google Scholar 

  2. Choi KM, Jang HJ, Kwak JH, Kim JH, Ahn JH (2014) Management of postoperative bilomas and biliary injuries associated with laparoscopic cholecystectomy with intrabiliary ethanol ablation and micro-coil embolization. Hepatogastroenterology 61(129):27–30

    PubMed  Google Scholar 

  3. Peitzman AB, Watson GA, Marsh JW (2015) Acute cholecystitis: when to operate and how to do it safely. J Trauma Acute Care Surg 78(1):1–12

    Article  PubMed  Google Scholar 

  4. Stewart L (2014) Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am 94(2):297–310. doi:10.1016/j.suc.2014.01.008

    Article  PubMed  Google Scholar 

  5. Kaplan D, Inaba K, Chouliaras K, Low GM, Benjamin E, Lam L, Grabo D, Demetriades D (2014) Subtotal cholecystectomy and open total cholecystectomy: alternatives in complicated cholecystitis. Am Surg 80(10):953–955

    PubMed  Google Scholar 

  6. Jabłońska B (2013) Hepatectomy for bile duct injuries: when is it necessary? World J Gastroenterol 19(38):6348–6352. doi:10.3748/wjg.v19.i38.6348

    Article  PubMed  PubMed Central  Google Scholar 

  7. Li J, Frilling A, Nadalin S, Radunz S, Treckmann J, Lang H, Malago M, Broelsch CE (2010) Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy: a challenging situation. J Gastrointest Surg 14(2):344–351. doi:10.1007/s11605-009-1087-0

    Article  PubMed  Google Scholar 

  8. Yoh T, Okamura R, Nobuto Y, Wada S, Nakamura Y, Kato T, Nakayama H (2014) Timing of laparoscopic cholecystectomy for mild and moderate acute cholecystitis. Hepatogastroenterology 61(134):1489–1493

    PubMed  Google Scholar 

  9. Fullum TM, Downing SR, Ortega G, Chang DC, Oyetunji TA, Van Kirk K, Tran DD, Woods I, Cornwell EE, Turner PL (2013) Is laparoscopy a risk factor for bile duct injury during cholecystectomy? JSLS 17(3):365–370. doi:10.4293/108680813X13654754535638

    Article  PubMed  PubMed Central  Google Scholar 

  10. Iimuro Y, Okada T, Ohashi K, Uda Y, Suzumura K, Fujimoto J (2013) Salvage treatment of laparoscopic cholecystectomy-associated bile duct stenosis combining laparoscopic and endoscopic procedures: a case report. Asian J Endosc Surg 6(4):322–326. doi:10.1111/ases.12053

    Article  PubMed  Google Scholar 

  11. Frattaroli FM, Lai Q, Coiro S, Casciani E, Pappalardo G (2013) Mirizzi Syndrome in a patient with an accessory hepatic duct. Clin Ter 164(2):139–141. doi:10.7417/CT.2013.1533

    CAS  PubMed  Google Scholar 

  12. Huang Q, Yao HH, Shao F, Wang C, Hu YG, Hu S, Qiu LJ (2014) Analysis of risk factors for postoperative complication of repair of bile duct injury after laparoscopic cholecystectomy. Dig Dis Sci 59(12):3085–3091. doi:10.1007/s10620-014-3255-7

    Article  PubMed  Google Scholar 

  13. Gruttadauria S, Doria C, Cintorino D, Singhal D, Verzaro R, Foglieni CS, Marino IR, Fung JJ (2003) Outcomes in 139 cases of biliary tract reconstructions from a transplant surgery center. Exp Clin Transplant 1(2):73–78

    PubMed  Google Scholar 

  14. Thompson CM, Saad NE, Quazi RR, Darcy MD, Picus DD, Menias CO (2013) Management of iatrogenic bile duct injuries: role of the interventional radiologist. Radiographics 33(1):117–134. doi:10.1148/rg.331125044

    Article  PubMed  Google Scholar 

  15. Navarrete C, Gobelet JM (2012) Treatment of common bile duct injuries after surgery. Gastrointest Endosc Clin N Am 22(3):539–553. doi:10.1016/j.giec.2012.04.023

    Article  PubMed  Google Scholar 

  16. Feng WM, Bao Y, Tang CW, Fei MY, Guo HH, Tao YL, Xue T, Gong H, Cui G, Wang Y (2014) Optimal selection of methods for mini-invasive treatment of extrahepatic bile duct stones. Hepatogastroenterology 61(130):299–303

    PubMed  Google Scholar 

  17. Pagano D, Spada M, Parikh V, Tuzzolino F, Cintorino D, Maruzzelli L, Vizzini G, Luca A (2006) Strasberg’s classification. From Connor S, Garden OJ. Bile duct injury in the era of laparoscopic cholecystectomy. Br J Surg 93(158–168):18

    Google Scholar 

  18. Mularoni A, Grossi P, Gridelli B, Gruttadauria S (2014) Liver regeneration after liver resection: clinical aspects and correlation with infective complications. World J Gastroenterol 20(22):6953–6960. doi:10.3748/wjg.v20.i22.6953

    Article  PubMed  PubMed Central  Google Scholar 

  19. Scilletta R, Pagano D, Spada M, Mongiovì S, Pesce A, Portale TR, Guardabasso V, Puleo S, Gruttadauria S (2014) Comparative analysis of the incidence of surgical site infections in patients with liver resection for colorectal hepatic metastases after neoadjuvant chemotherapy. J Surg Res 188(1):183–189. doi:10.1016/j.jss.2013.11.1092 (Epub 2013 Nov 22)

    Article  PubMed  Google Scholar 

  20. Bogdanic B, Bosnjak Z, Budimir A, Augustin G, Milosevic M, Plecko V, Kalenic S, Fiolic Z, Vanek M (2013) Surveillance of surgical site infection after cholecystectomy using the hospital in Europe link for infection control through surveillance protocol. Surg Infect (Larchmt) 14(3):283–287. doi:10.1089/sur.2012.096

    Article  Google Scholar 

  21. Laux AT, Testa G, Goldstein RM, Cavaness KM (2014) The management of a complex bile duct injury after laparoscopic cholecystectomy. Am Surg 80(6):E175–E178

    PubMed  Google Scholar 

  22. Williamson JM (2014) Bile duct injury following laparoscopic cholecystectomy. Br J Hosp Med (Lond) 75(6):325–330. doi:10.12968/hmed.2014.75.6.325

    Article  CAS  Google Scholar 

  23. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL (2009) MakuuchiThe Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. doi:10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  24. Stilling NM, Fristrup C, Wettergren A, Ugianskis A, Nygaard J, Holte K, Bardram L, Sall M, Mortensen MB (2015) Long-term outcome after early repair of iatrogenic bile duct injury. A national Danish multicentre study. HPB (Oxford) 17(5):394–400. doi:10.1111/hpb.12374

    Article  Google Scholar 

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Authors and Affiliations

  1. Unit of Abdominal Surgery and Organ Transplantation, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Via E. Tricomi 5, 90127, Palermo, Italy

    Alessandro Tropea, Duilio Pagano, Marco Spada & Salvatore Gruttadauria

  2. Department of Surgery, University Hospital “Policlinico-Vittorio Emanuele”, Catania, Italy

    Antonio Biondi

Authors
  1. Alessandro Tropea
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  2. Duilio Pagano
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  3. Antonio Biondi
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  4. Marco Spada
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  5. Salvatore Gruttadauria
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Correspondence to Salvatore Gruttadauria.

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Conflict of interest

This manuscript has not been published and is not under consideration elsewhere. We declare that all authors are in agreement on the content of the manuscript and have no potential conflicts of interest. We have nothing to disclose regarding sources of support in the form of grants, equipment, and/or pharmaceuticals. The authors of this manuscript have no conflicts of interest, as described by this journal, to disclose.

Ethical approval

All patient data were obtained under appropriate consent using a study protocol approved by the Institutional Review Board at ISMETT.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Tropea, A., Pagano, D., Biondi, A. et al. Treatment of the iatrogenic lesion of the biliary tree secondary to laparoscopic cholecystectomy: a single center experience. Updates Surg 68, 143–148 (2016). https://doi.org/10.1007/s13304-016-0347-2

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  • DOI: https://doi.org/10.1007/s13304-016-0347-2

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