Mechanisms of major biliary injury during laparoscopic cholecystectomy.

Published

Journal Article

Laparoscopic cholecystectomy has become the procedure of choice for surgical removal of the gallbladder. The most significant complication of this new technique is injury to the bile duct. Twelve cases of bile duct injury during laparoscopic cholecystectomy were reviewed. Eight injuries were of a classic type: misidentification of the common duct for the cystic duct, resection of part of the common and hepatic ducts, and associated right hepatic arterial injury. Another injury was similar: clip ligation of the distal common duct with proximal ligation and division of the cystic duct, resulting in biliary obstruction and leakage. Three complications arose from excessive use of cautery or laser in the region of the common duct, resulting in biliary strictures. Evaluation of persistent diffuse abdominal pain led to the recognition of ductal injury in most patients. Ultimately, 10 patients required a Roux-en-Y hepaticojejunostomy to provide adequate biliary drainage. One patient had a successful direct common duct repair, and the remaining patient underwent endoscopic dilatation.

Full Text

Duke Authors

Cited Authors

  • Davidoff, AM; Pappas, TN; Murray, EA; Hilleren, DJ; Johnson, RD; Baker, ME; Newman, GE; Cotton, PB; Meyers, WC

Published Date

  • March 1992

Published In

Volume / Issue

  • 215 / 3

Start / End Page

  • 196 - 202

PubMed ID

  • 1531913

Pubmed Central ID

  • 1531913

International Standard Serial Number (ISSN)

  • 0003-4932

Digital Object Identifier (DOI)

  • 10.1097/00000658-199203000-00002

Language

  • eng

Conference Location

  • United States