Factors influencing the results of treatment of bile duct injuries during laparoscopic cholecystectomy.
BACKGROUND
The short-term results of repair of laparoscopic bile duct injuries have been well discussed, but the long-term results have been rarely reported. This study was undertaken to evaluate the factors influencing the outcome of repair of bile duct injuries caused by laparoscopic cholecystectomy.


METHODS
The outcomes of repair of bile duct injuries caused by laparoscopic cholecystectomy in 31 patients were reviewed retrospectively, and the effects of injury recognition, cholangiography, repair modality and techniques on the long-term results were analyzed.


RESULTS
Bile duct injuries were repaired successfully in 19 (95%) of 20 patients with injuries who had been recognized intraoperatively, and in 10 (90%) of 11 patients with injuries who had been recognized postoperatively. Repair was successful in 29 (93%) of the 31 patients after complete cholangiography. Closure of partial division, laceration, or small perforation of the bile duct with or without T tube drainage was satisfactory in the 23 patients. End to end repair over T tube was successful in 2 transection patients, who were detected intraoperatively. Roux-en-Y hepaticojejunostomy was used successfully to repair transection, excision or stricture of the bile duct in 4 of 5 patients (80%).


CONCLUSIONS
Early detection of bile duct injuries caused by laparoscopy, complete evaluation of the biliary duct, and appropriate surgical modality and techniques are helpful to improve the results of repair for laparoscopic bile duct injuries.
Li
Li-Bo
LB
Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou 310016, China. lilibo1970@hotmail.com
Cai
Xiu-Jun
XJ
Mou
Yi-Ping
YP
Wei
Qi
Q
Wang
Xian-Fa
XF
D017677:Age Distribution; D000713:Anastomosis, Roux-en-Y; D001649:Bile Duct Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D001652:Bile Ducts / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016896:Treatment Outcome