Skip to main content
SpringerLink
Log in

Management of major bile duct injury associated with laparoscopic cholecystectomy

  • Original articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Bile duct injury is a major complication of laparoscopic cholecystectomy. The purpose of this study was to evaluate our management strategy and outcomes for the treatment of such injuries.

Methods

We studied 54 consecutive patients who had de novo bile duct injury (n = 20) or prior biliary injury repair (n = 34) associated with laparoscopic cholecystectomy. All patients were managed using a multidisciplinary approach.

Results

Definitive operation, almost always Roux-en-Y hepaticojejunostomy, was required in 85% of patients. We inserted external percutaneous biliary catheters in 98% of cases prior to surgery. There were no operative deaths, and the 30-day complication rate was 20%. Eight patients (15%) were managed nonoperatively. Overall, 96% of patients had no long-term, objectively definable biliary sequelae.

Conclusions

Treatment of bile duct injury associated with laparoscopic cholecystectomy is optimally done using a multidisciplinary approach. Surgical reconstruction is required in most cases and can be safely accomplished with minimal morbidity and excellent long-term outcomes.

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

Similar content being viewed by others

References

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

    CAS  PubMed  Google Scholar 

  2. Blumgart LH (1994) Hilar and intrahepatic biliary enteric anastomosis. Surg Clin North Am 74: 845–863

    CAS  PubMed  Google Scholar 

  3. Doctor N, Dooley JS, Dick R, Watkinson A, Rolles K, Davidson BR (1998) Multidisciplinary approach to biliary complications of laparoscopic cholecystectomy. Br J Surg 85: 627–632

    Article  CAS  PubMed  Google Scholar 

  4. Hart R, Passi R, Hall W (2000) Long-term outcome after repair of major bile duct injury created during laparoscopic cholecystectomy. J Hepat Pancreat Biliary Surg 2: 325–332

    Google Scholar 

  5. Johnson SR, Koehler A, Pennington LK, Hanto DW (2000) Long-term results of surgical repair of bile duct injuries following laparoscopic cholecystectomy. Surgery 128: 668–677

    Article  CAS  PubMed  Google Scholar 

  6. Lillemoe KD, Melton GB, Cameron JL, Pitt HA, Campell KA, Talamini MA, Sauter PA, Coleman J, Yeo CJ (2000) Postoperative bile duct strictures: management and outcome in the 1990s. Ann Surg 232: 430–441

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Lillemoe KD, Martin SA, Cameron JL, Yeo CJ, Talamini MA, Kaushal S, Coleman J, Venbrux AC, Savader SJ (1997) Major bile duct injuries during laparoscopic cholecystectomy: follow-up after combined surgical and radiologic management. Ann Surg 225: 459–471

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. MacFadyen BV, Vecchio R, Ricardo AE, Mathis CR (1998) Bile duct injury after laparoscopic cholecystectomy: the United States experience. Surg Endosc 12: 315–321

    Article  PubMed  Google Scholar 

  9. Pitt HA, Kaufman SL, Coleman J, White RI, Cameron JL (1989) Benign postoperative biliary strictures: operate or dilate? Ann Surg 210: 417–427

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Rossi RL, Tsao JI (1994) Biliary reconstruction. Surg Clin North Am 74: 825–841 discussion 843-844

    CAS  PubMed  Google Scholar 

  11. Savader SJ, Lillemoe KD, Prescott CA, Winick AB, Venbrux AC, Lund GB, Mitchell SE, Cameron JL, Osterman FA (1997) Laparoscopic cholecystectomy-related bile duct injuries: a health and financial disaster. Ann Surg 225: 268–273

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Soper NJ, Flye MW, Brunt LM, Stockman PT, Sicard GA, Picus D, Edmundowicz SA, Aliperti G (1993) Diagnosis and management of biliary complications of laparoscopic cholecystectomy. Am J Surg 165: 663–669

    Article  CAS  PubMed  Google Scholar 

  13. Stewart L, Way LW (1995) Bile duct injuries during laparoscopic cholecystectomy: factors that influence the results of treatment. Arch Surg 130: 1123–1129

    Article  CAS  PubMed  Google Scholar 

  14. 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

    CAS  PubMed  Google Scholar 

  15. Sutherland F, Launois B, Stanescu M, Campion JP, Spiliopoulos Y, Stasik C (1999) A refined approach to the repair of postcholecystectomy bile duct strictures. Arch Surg 134: 299–302

    Article  CAS  PubMed  Google Scholar 

  16. Vitale GC, Stephens G, Wieman TJ, Larson GM (1993) Use of endoscopic retrograde cholangiopancreatography in the management of biliary complications after laparoscopic cholecystectomy. Surgery 114: 806–814

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO, 80262, USA

    T. N. Robinson, G. V. Stiegmann, J. D. Durham, S. I. Johnson, M. E. Wachs, A. D. Serra & D. A. Kumpe

Authors
  1. T. N. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. V. Stiegmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. D. Durham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. I. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. E. Wachs
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. D. Serra
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D. A. Kumpe
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Robinson, T.N., Stiegmann, G.V., Durham, J.D. et al. Management of major bile duct injury associated with laparoscopic cholecystectomy. Surg Endosc 15, 1381–1385 (2001). https://doi.org/10.1007/s00464-001-8156-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-001-8156-0

Key words

Search

Navigation