Abstract
IntroductionBile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Several series have described a 0.5% to 0.6% incidence of bile duct injury during laparoscopic cholecystectomy. The aim of this study was to analyze the presentation, characteristics, related investigation, and treatment results of major bile duct injuries after laparoscopic cholecystectomy.Case presentationA rare case of a 48-year-old Greek woman with a triple bile duct injury (right and left hepatic duct ligation and common bile duct cross-section) is presented. A Roux en Y hepaticojejunostomy was performed after repeated endoscopic retrograde cholangiopancreatographies, percutaneous transhepatic catheterization of the ducts and magnetic resonance cholangiographies to delineate the biliary anatomy and assess the level of injury.ConclusionEarly recognition and an adequate multidisciplinary approach are the cornerstones for the optimal final outcome. Suboptimal management of injuries often leads to more extensive damage to the biliary tree and its vasculature. Early referral to a tertiary care center with experienced hepatobiliary surgeons and skilled interventional radiologists would appear to be necessary to assure optimal results.
Highlights
Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy
The management of patients following major bile duct injury is a surgical challenge often requiring the skills of experienced hepatobiliary surgeons at tertiary referral centers [7]
Minor injuries include laceration of the cystic to common bile duct junction and laceration of the common hepatic duct over less than 25% of the duct diameter
Summary
Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Bile duct injuries are reported to be more severe and more common when compared to open cholecystectomy [2,3,4,5] with a reported incidence of up to 0.6% for laparoscopic versus 0.1% for open cholecystectomy [5]. These injuries (page number not for citation purposes). The management of patients following major bile duct injury is a surgical challenge often requiring the skills of experienced hepatobiliary surgeons at tertiary referral centers [7]. Collaboration among surgeons, gastroenterologists and interventional radiologists is imperative in the care of such injuries
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