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Mechanisms of major biliary injury during laparoscopic cholecystectomy.

Publication ,  Journal Article
Davidoff, AM; Pappas, TN; Murray, EA; Hilleren, DJ; Johnson, RD; Baker, ME; Newman, GE; Cotton, PB; Meyers, WC
Published in: Ann Surg
March 1992

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.

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Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

March 1992

Volume

215

Issue

3

Start / End Page

196 / 202

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Surgery
  • Middle Aged
  • Male
  • Laparoscopy
  • Intraoperative Complications
  • Humans
  • Female
  • Cholecystectomy
  • Cholangiography
 

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Davidoff, A. M., Pappas, T. N., Murray, E. A., Hilleren, D. J., Johnson, R. D., Baker, M. E., … Meyers, W. C. (1992). Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg, 215(3), 196–202. https://doi.org/10.1097/00000658-199203000-00002
Davidoff, A. M., T. N. Pappas, E. A. Murray, D. J. Hilleren, R. D. Johnson, M. E. Baker, G. E. Newman, P. B. Cotton, and W. C. Meyers. “Mechanisms of major biliary injury during laparoscopic cholecystectomy.Ann Surg 215, no. 3 (March 1992): 196–202. https://doi.org/10.1097/00000658-199203000-00002.
Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg. 1992 Mar;215(3):196–202.
Davidoff, A. M., et al. “Mechanisms of major biliary injury during laparoscopic cholecystectomy.Ann Surg, vol. 215, no. 3, Mar. 1992, pp. 196–202. Pubmed, doi:10.1097/00000658-199203000-00002.
Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME, Newman GE, Cotton PB, Meyers WC. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg. 1992 Mar;215(3):196–202.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

March 1992

Volume

215

Issue

3

Start / End Page

196 / 202

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Surgery
  • Middle Aged
  • Male
  • Laparoscopy
  • Intraoperative Complications
  • Humans
  • Female
  • Cholecystectomy
  • Cholangiography