Role of laparoscopy in the immediate, intermediate, and long-term management of iatrogenic bile duct injuries during laparoscopic cholecystectomy

Autor: Drago Julian, de Santibañes Martín, Palavecino Martín, Sánchez Clariá Rodrigo, Arbues Guillermo, Mazza Oscar, Pekolj Juan
Rok vydání: 2022
Předmět:
Zdroj: Langenbeck's Archives of Surgery. 407:663-673
ISSN: 1435-2451
1435-2443
DOI: 10.1007/s00423-022-02452-5
Popis: 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.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.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.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.
Databáze: OpenAIRE
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