[Bile duct injury after cholecystectomy: risk of mortality substantially higher].
Previous studies showed that bile duct injury after cholecystectomy is associated with substantial morbidity and a negative effect on Quality of Life. In a recent study, patients with a bile duct injury after cholecystectomy exhibited a 3-fold increase in mortality during a follow-up period of nine years compared to patients without injury. This is the first study to demonstrate a negative impact of bile duct injury on survival. Repair by a less experienced surgeon leads to an 11% higher mortality during follow-up. Cholangiography should probably be performed routinely during cholecystectomy. A bile duct lesion should be suspected when the patient has not recovered within 48 hours. Endoscopic or percutaneous treatment of stenoses or leakage is usually successful, even after several weeks.
Gouma
D J
DJ
Afd. Algemene Chirurgie, Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.660, 1100 DD Amsterdam. d.j.gouma@amc.uva.nl
Rauws
E A
EA
Laméris
J S
JS
D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery; D002758:Cholangiography / Q000379:methods; D002763:Cholecystectomy / Q000009:adverse effects* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D009426:Netherlands; D011788:Quality of Life; D012307:Risk Factors; D013997:Time Factors