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- Title
Role of laparoscopy in the immediate, intermediate, and long-term management of iatrogenic bile duct injuries during laparoscopic cholecystectomy.
- Authors
Julian, Drago; Martín, de Santibañes; Martín, Palavecino; Rodrigo, Sánchez Clariá; Guillermo, Arbues; Oscar, Mazza; Juan, Pekolj
- Abstract
Purpose: Bile duct injuries (BDI) during a laparoscopic cholecystectomy still remain as one of the most feared complications in surgery. The use of laparoscopy for its management is a controversial subject of discussion. The purpose of this study is to assess the amount of possibilities that a laparoscopic approach allows in its resolution. Methods: A retrospective analysis of all the patients diagnosed with BDI at our center was carried out. The analysis was made considering three different scenarios in which laparoscopy can be used: (1) intraoperative management of BDI; (2) postoperative management of bile peritonitis; (3) deferred treatment of BDI. Results: We analyzed 22 patients in total who were divided into three groups according to the different scenarios proposed. In the first group, the applicability of laparoscopy was 45%, some complications occurred in two patients, and primary patency was obtained in seven. In the second group, four of them presented a grade III complication. In the third group, the applicability of laparoscopy was 13.6%. Only one patient presented a IIIa complication and primary patency was obtained in all of them. Conclusions: Laparoscopy plays a more important role in BDI management every day. This approach, in selected cases, is associated with good long-term results and perioperative advantages of a minimally invasive approach.
- Subjects
BILE ducts; LAPAROSCOPY; LAPAROSCOPIC surgery; CHOLECYSTECTOMY; SURGICAL complications; POSTOPERATIVE care
- Publication
Langenbeck's Archives of Surgery, 2022, Vol 407, Issue 2, p663
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s00423-022-02452-5