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Laparoscopic Repair of Post-cholecystectomy Bile Duct Injury: an Advance in Surgical Management

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Despite widespread advances in laparoscopic surgery, laparoscopic repair of post-cholecystectomy bile duct injury (BDI) has rarely been reported related mainly to technical difficulty. We describe three cases of BDI treated laparoscopically with one illustrated by a video. With our gained experience in hepatic pedicle dissection during laparoscopic pancreaticoduodenectomy, we decided to perform laparoscopic repair of BDI in patients with an intact biliary confluence without vascular injury. Three patients were operated including two women: one was re-operated by subcostal incision for peritonitis and two had undergone cholecystectomy without conversion. Surgical technique is detailed in the manuscript and the video. Laparoscopic repair was performed between 45 and 300 days after cholecystectomy. Surgery lasted between 250 and 270 min with no conversion and no transfusion. The postoperative course was uneventful with a hospital stay ranging from 7 to 9 days. After a mean follow-up of 9–33 months, patients were symptom free with normal liver function tests. The laparoscopic approach can be safely and effectively proposed to a subgroup of patients with BDI. This approach has the advantages of the laparoscopic approach and represents the main new surgical advancement in the management of this complication.

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Abbreviations

BDI:

Bile duct injury

BF:

Biliary fistula

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Authors and Affiliations

  1. Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France

    Safi Dokmak MD, Najat Amharar MD, Béatrice Aussilhou MD, François Cauchy MD, Alain Sauvanet MD, Jacques Belghiti MD & Olivier Soubrane MD

  2. Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France

    Safi Dokmak MD, Najat Amharar MD, Béatrice Aussilhou MD, François Cauchy MD, Alain Sauvanet MD, Jacques Belghiti MD & Olivier Soubrane MD

Authors
  1. Safi Dokmak MD
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  2. Najat Amharar MD
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  3. Béatrice Aussilhou MD
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  4. François Cauchy MD
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  5. Alain Sauvanet MD
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  6. Jacques Belghiti MD
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  7. Olivier Soubrane MD
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Corresponding author

Correspondence to Safi Dokmak MD.

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The authors state that informed consent was obtained from all patients, and that the study protocol has been approved by the institute’s committee on human research.

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The authors declare that they have no conflict of interest.

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Dokmak, S., Amharar, N., Aussilhou, B. et al. Laparoscopic Repair of Post-cholecystectomy Bile Duct Injury: an Advance in Surgical Management. J Gastrointest Surg 21, 1368–1372 (2017). https://doi.org/10.1007/s11605-017-3400-7

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  • DOI: https://doi.org/10.1007/s11605-017-3400-7

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