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Operative Repair of Common Bile Duct Injury

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Book cover Management of Benign Biliary Stenosis and Injury

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Abstract

Injury to the extrahepatic bile duct occurs in approximately 1 in 300 laparoscopic cholecystectomies. Most bile duct injuries result from errors of cognition leading to anatomical disorientation. The injury is often missed by the operating surgeon at the time of cholecystectomy. Key management principles are control of bile leakage and sepsis and definition of a concomitant vascular injury. Immediate repair may carry a high failure rate, and if considered, should be undertaken by a second surgeon who is an expert in bile duct repair and not party to the original injury. For most bile duct injuries, the Hepp-Couinaud technique of hepaticojejunostomy extending along the left hepatic duct is recommended. SCARF, a practical checklist to assist developing the optimum management algorithm, is presented.

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Abbreviations

CBD:

Common bile duct

CHD:

Common hepatic duct

LHD:

Left hepatic duct

RHD:

Right hepatic duct

CHA:

Common hepatic artery

PHA:

Proper hepatic artery

RHA:

Right hepatic artery

LHA:

Left hepatic artery

BDI:

Bile duct injury

VBI:

Vasculobiliary injury

HRQOL:

Health-related quality of life

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK

    Damian J. Mole M.B.Ch.B., Ph.D., F.R.C.S. & O. James Garden C.B.E., M.D., F.R.C.S.Ed.

Authors
  1. Damian J. Mole M.B.Ch.B., Ph.D., F.R.C.S.
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  2. O. James Garden C.B.E., M.D., F.R.C.S.Ed.
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Corresponding author

Correspondence to Damian J. Mole M.B.Ch.B., Ph.D., F.R.C.S. .

Editor information

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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© 2015 Springer International Publishing Switzerland

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Mole, D.J., Garden, O.J. (2015). Operative Repair of Common Bile Duct Injury. 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_28

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  • DOI: https://doi.org/10.1007/978-3-319-22273-8_28

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22272-1

  • Online ISBN: 978-3-319-22273-8

  • eBook Packages: MedicineMedicine (R0)

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