Abstract
Injury to the extrahepatic bile duct occurs in approximately 1 in 300 laparoscopic cholecystectomies. Most bile duct injuries result from errors of cognition leading to anatomical disorientation. The injury is often missed by the operating surgeon at the time of cholecystectomy. Key management principles are control of bile leakage and sepsis and definition of a concomitant vascular injury. Immediate repair may carry a high failure rate, and if considered, should be undertaken by a second surgeon who is an expert in bile duct repair and not party to the original injury. For most bile duct injuries, the Hepp-Couinaud technique of hepaticojejunostomy extending along the left hepatic duct is recommended. SCARF, a practical checklist to assist developing the optimum management algorithm, is presented.
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Abbreviations
- CBD:
-
Common bile duct
- CHD:
-
Common hepatic duct
- LHD:
-
Left hepatic duct
- RHD:
-
Right hepatic duct
- CHA:
-
Common hepatic artery
- PHA:
-
Proper hepatic artery
- RHA:
-
Right hepatic artery
- LHA:
-
Left hepatic artery
- BDI:
-
Bile duct injury
- VBI:
-
Vasculobiliary injury
- HRQOL:
-
Health-related quality of life
References
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6:172–87.
Scotland I. Health care diagnoses. (2011–2012).
Centre, H.A.S.C.I. Hospital Episode Statistics, Admitted Patient Care, England—2012-13. (2012-2013).
Stewart L. Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 2014;94:297–310.
Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101–25.
Connor S, Garden OJ. Bile duct injury in the era of laparoscopic cholecystectomy. Br J Surg. 2006;93:158–68.
Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25:1241–4.
Davidoff AM, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg. 1992;215:196–202.
Connor SJ, Perry W, Nathanson L, Hugh TB, Hugh TJ. Using a standardized method for laparoscopic cholecystectomy to create a concept operation-specific checklist. HPB (Oxford). 2014;16:422–9.
Dekker SW, Hugh TB. Laparoscopic bile duct injury: understanding the psychology and heuristics of the error. ANZ J Surg. 2008;78:1109–14.
Fingerhut A, et al. ATOM, the all-inclusive, nominal EAES classification of bile duct injuries during cholecystectomy. Surg Endosc. 2013;27:4608–19.
Sarno G, et al. Cholecystectomy-related bile duct and vasculobiliary injuries. Br J Surg. 2012;99:1129–36.
Strasberg SM, Helton WS. An analytical review of vasculobiliary injury in laparoscopic and open cholecystectomy. HPB (Oxford). 2011;13:1–14.
Mays ET, Wheeler CS. Demonstration of collateral arterial flow after interruption of hepatic arteries in man. N Engl J Med. 1974;290:993–6.
Pulitanò C, Parks RW, Ireland H, Wigmore SJ, Garden OJ. Impact of concomitant arterial injury on the outcome of laparoscopic bile duct injury. Am J Surg. 2011;201:238–44.
Iannelli A, et al. Primary versus delayed repair for bile duct injuries sustained during cholecystectomy: results of a survey of the Association Francaise de Chirurgie. HPB (Oxford). 2013;15:611–6.
Pekolj J, et al. Intraoperative management and repair of bile duct injuries sustained during 10,123 laparoscopic cholecystectomies in a high-volume referral center. J Am Coll Surg. 2013;216:894–901.
Hepp J, Couinaud C. Approach to and use of the left hepatic duct in reparation of the common bile duct. Presse Med. 1956;64:947–8.
Hepp J. Hepaticojejunostomy using the left biliary trunk for iatrogenic biliary lesions: the French connection. World J Surg. 1985;9:507–11.
Rose JB, et al. Use the duodenum, it’s right there: a retrospective cohort study comparing biliary reconstruction using either the jejunum or the duodenum. JAMA Surg. 2013;148:860–5.
Barbier L, Souche R, Slim K, Ah-Soune P. Long-term consequences of bile duct injury after cholecystectomy. J Visc Surg. 2014;151:269–79.
Truant S, Boleslawski E, Lebuffe G, Sergent G, Pruvot FR. Hepatic resection for post-cholecystectomy bile duct injuries: a literature review. HPB (Oxford). 2010;12:334–41.
Laurent A, et al. Major hepatectomy for the treatment of complex bile duct injury. Ann Surg. 2008;248:77–83.
Thomson BN, Parks RW, Madhavan KK, Garden OJ. Liver resection and transplantation in the management of iatrogenic biliary injury. World J Surg. 2007;31:2363–9.
Booij KA, et al. Partial liver resection because of bile duct injury. Dig Surg. 2013;30:434–8.
Sikora SS. Management of post-cholecystectomy benign bile duct strictures: review. Indian J Surg. 2012;74:22–8.
Pitt HA, et al. Improved outcomes of bile duct injuries in the 21st century. Ann Surg. 2013;258:490–9.
Sulpice L, Garnier S, Rayar M, Meunier B, Boudjema K. Biliary cirrhosis and sepsis are two risk factors of failure after surgical repair of major bile duct injury post-laparoscopic cholecystectomy. Langenbecks Arch Surg. 2014;399:601–8.
Lubikowski J, et al. Surgical management and outcome of bile duct injuries following cholecystectomy: a single-center experience. Langenbecks Arch Surg. 2011;396:699–707.
Ejaz A, et al. Long-Term Health-Related Quality of Life after Iatrogenic Bile Duct Injury Repair. J Am Coll Surg. 2014.
Landman MP, Feurer ID, Moore DE, Zaydfudim V, Pinson CW. The long-term effect of bile duct injuries on health-related quality of life: a meta-analysis. HPB (Oxford). 2013;15:252–9.
Dominguez-Rosado I, et al. Quality of life in bile duct injury: 1-, 5-, and 10-year outcomes after surgical repair. J Gastrointest Surg. 2014;18:2089–94.
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Mole, D.J., Garden, O.J. (2015). Operative Repair of Common Bile Duct Injury. In: Dixon, E., Vollmer Jr., C., May, G. (eds) Management of Benign Biliary Stenosis and Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-22273-8_28
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DOI: https://doi.org/10.1007/978-3-319-22273-8_28
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