title: Treatment of the iatrogenic lesion of the biliary tree secondary to laparoscopic cholecystectomy: a single center experience.
abstract: Surgical bile duct injury (SBDI), during laparoscopic cholecystectomy, is a worldwide ongoing problem. The purpose of this study is to analyze a single center retrospective experience with this topic. From 1999 to 2012, 30 patients with diagnosis of SBDI after laparoscopic cholecystectomy performed in other institute for gallbladder lithiasis and then transferred to our facility were enrolled in this analysis. We considered in the study the following parameters: classification and site of the bile duct injury, infective complications and therapeutic management according to early or late referral. Twenty four patients (80 %) had a SBDI type E1; a concomitant vascular injury was described in 3/30 (10 %) in right hepatic artery. 11 patients had HJJ as primary surgical treatment in our hospital. Surgical site infection was documented in 9/30 (30 %). The most common micro-organisms documented in SSI were E. coli with an incidence of 55.5 % of SSI. Worse infective complications were detected in the late referral group. Complex SBDI occurred during laparoscopic cholecystectomy should be early referred to advanced hepatobiliary program, for appropriate multidisciplinary management.
authors.affiliation: Unit of Abdominal Surgery and Organ Transplantation, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Via E. Tricomi 5, 90127, Palermo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tropea
authors.affiliation: Unit of Abdominal Surgery and Organ Transplantation, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Via E. Tricomi 5, 90127, Palermo, Italy.
authors.forename: Duilio
authors.initials: D
authors.lastname: Pagano
authors.affiliation: Department of Surgery, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Unit of Abdominal Surgery and Organ Transplantation, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Via E. Tricomi 5, 90127, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Spada
authors.affiliation: Unit of Abdominal Surgery and Organ Transplantation, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Via E. Tricomi 5, 90127, Palermo, Italy. sgruttadauria@ismett.edu.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gruttadauria
mesh_terms: D001649:Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001652:Bile Ducts / Q000293:injuries*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003657:Decision Making; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease
keywords: Endoscopic retrograde cholangiopancreatography; Gallbladder lithiasis; Percutaneous transhepatic cholangiography; Surgical bile duct injury