Bile duct injuries in the era of laparoscopic cholecystectomy.
By the introduction of laparoscopic cholecystectomy a new field of surgical development has been opened, resulting in the reduction of conventional surgical trauma, and giving the chance to the patient seeking for less postoperative pain, short hospital stay and quick return to activity and work. In spite of these advantages, many laparoscopic cholecystectomy related complications occurred, especially in the period of the learning curve. Due to the special technical requirements, problems of the two dimensional vision, depth perception and hand-eye coordination guided to injuries of the bile ducts, which reached a high rate of 3%. This rate is ten times more when compared with conventional cholecystectomy. The authors present a detailed account of the causes of the injuries, their typical localisation and the best way to avoid and treat them.
Metzger
P
P
Department of Surgery, Postgraduate Medical School, HI University of Health Sciences, Budapest, Hungary.
Gamal
E M
EM
D000203:Activities of Daily Living; D001652:Bile Ducts / Q000293:injuries*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D003135:Common Bile Duct / Q000293:injuries; D003867:Depth Perception; D004210:Dissection; D004598:Electrosurgery; D006500:Hepatic Duct, Common / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications / Q000145:classification / Q000517:prevention & control / Q000601:surgery; D007858:Learning; D007902:Length of Stay; D010149:Postoperative Pain / Q000517:prevention & control; D011182:Postoperative Care; D011597:Psychomotor Performance; D014785:Vision, Ocular