[High number of bile duct injuries in cholecystectomy. There is a connection with the use of the laparoscopic technique].
During the 1990s 152 cases with injuries of the bile ducts in connection with cholecystectomy in 81% performed via laparoscopic technique were reported to the Swedish Patients' Insurance Company. In 116 cases there was a lesion of the common duct, in 24 cases there was a defect in the duct. A peroperative cholangiogram was carried out in more than two thirds of the cases. Lesions of the common duct could in most cases be repaired with suture and drainage. In 44 cases, however, a Roux anastomosis to the small intestine had to be performed. To prevent bile duct injuries during cholecystectomy, the anatomy of the operative field must be clarified before tubular structures are divided. Peroperative cholangiography as routine during cholecystectomy is recommended.
Larsson
M
M
Kirurgiska kliniken, Danderyds sjukhus.
Räf
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007345:Insurance Claim Review; D007430:Intraoperative Care / Q000379:methods / Q000592:standards; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013548:Sweden / Q000453:epidemiology
Många gallgångsskador vid kolecystektomi. Klart samband med användning av laparoskopisk teknik.