Bile duct injury and bile leakage in laparoscopic cholecystectomy.
Between January 1991 and July 1992, 350 laparoscopic cholecystectomies were performed. There were six biliary complications (1.7 per cent): common bile duct (CBD) injury (one patient), delayed CBD necrosis (one), immediate postoperative bile leakage (one) and delayed bile leakage (three). All six patients required laparotomy. Primary repair with long-arm T tube splinting for 3 months was performed for the CBD injury. Religation of the cystic duct was carried out after immediate postoperative bile leakage. Laparotomy with T tube choledochostomy only was performed in the three patients with delayed bile leakage, and hepatojejunostomy Roux-en-Y was undertaken for CBD necrosis. The patient with primary repair of the CBD injury required choledochojejunostomy Roux-en-Y 18 months later for stenosis. Episodes of intermittent cholangitis occurred in the patient with CBD necrosis. The outcome for the four patients with bile leakage was good. There were no deaths.
Huang
S M
SM
Department of Surgery, Veterans General Hospital, National Yang-Ming Medical College, Taipei, Taiwan, Republic of China.
Wu
C W
CW
Hong
H T
HT
Ming-Liu
King
K L
KL
Lui
W Y
WY
D000328:Adult; D000368:Aged; D001646:Bile; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002983:Clinical Competence; D003135:Common Bile Duct / Q000293:injuries* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors