| Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy: a challenging situation. | |
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MedLine Citation:
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PMID: 19911237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Injury to a segmental or sectoral bile duct is a rare event in laparoscopic cholecystectomy; its diagnosis and management may be difficult. PATIENTS AND METHODS: Between April 1998 and December 2006, 73 patients referred to the author's tertiary center for management of postcholecystectomy biliary complications were studied. The patients with segmental/sectoral bile duct injury were divided into two groups: injury to a duct which drains at least one Couinaud segment (type 1) or injury to a minor biliary radical in the gallbladder fossa (type 2). Beside the management of concomitant vascular or other biliary injury, type 1 segmental/sectoral duct injury was repaired by biliary-enteric anastomosis and type 2 by oversewing. RESULTS: Ten out of 73 referred patients had segmental/sectoral duct injuries (eight type 1, two type 2). Despite multiple radiological imaging and endoscopic procedures, in seven patients, the lesion was identified only by precise surgical dissection. The median length of hospital treatment was 26 (range 9-47) days. One patient died due to sepsis before any definitive treatment. During the mean follow-up of 43 (range 27-111) months, seven patients remained asymptomatic while two patients developed biliary anastomotic strictures requiring intervention. CONCLUSION: Segmental/sectoral duct injury is difficult to be assessed by conventional radiological diagnostics and should be taken into consideration in every case of bile leakage. Surgical treatment, adapted to the type of lesion, generally results in a favorable outcome. |
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Authors:
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Jun Li; Andrea Frilling; Silvio Nadalin; Sonia Radunz; Juergen Treckmann; Hauke Lang; Massimo Malago; Christoph Erich Broelsch |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 14 ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-29 Completed Date: 2010-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 344-51 Citation Subset: IM |
Affiliation:
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Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bile Ducts
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injuries*,
surgery* Cholecystectomy, Laparoscopic / adverse effects* Humans Postoperative Complications / diagnosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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