Iatrogenic Lesions of the Extrahepatic Bile Ducts during Laparoscopic Cholecystectomy

Abstract

Introduction: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones. However, this surgical approach is also associated with potential complications. The most frequent of them, related to a very serious prognosis, are lesions of the extrahepatic bile ducts. Their understanding is a prerequisite for preventing them. Aim: The aim of this paper is to present in a concentrated form the iatrogenic lesions of the biliary tract as a major group of complications during laparoscopic cholecystectomy and the methods for their treatment. Materials and Methods: Information from the specialized surgical literature was used and, for comparison and illustration, we presented data about 30 patients with complications after laparoscopic cholecystectomy, treated in the Department of General and Hepato-Pancreatic Surgery at the University Hospital `Aleksandrovska` - Sofia for the period 2000- 2015. 11 (36.7%) of them are men and 19 (63.3%) - women, aged 38 to 65 years, with an average age of 50. Results: The clinical material from the Department of General and Hepato-Pancreatic Surgery is an illustration of some of the possible iatrogenic lesions of the extrahepatic bile ducts during laparoscopic cholecystectomy reported in the world literature. Their managing fit the generally accepted rules and priority was given to the open surgical methods. Conclusions: Minimally invasive methods, in particular laparoscopic cholecystectomy, are rarely associated with complications. The injuries of extrahepatic bile ducts are of great significance and often thorough knowledge and multidisciplinary approach in their treatment are required to achieve the best results.