title: Laparoscopic Repair of Post-cholecystectomy Bile Duct Injury: an Advance in Surgical Management.
abstract: Despite widespread advances in laparoscopic surgery, laparoscopic repair of post-cholecystectomy bile duct injury (BDI) has rarely been reported related mainly to technical difficulty. We describe three cases of BDI treated laparoscopically with one illustrated by a video. With our gained experience in hepatic pedicle dissection during laparoscopic pancreaticoduodenectomy, we decided to perform laparoscopic repair of BDI in patients with an intact biliary confluence without vascular injury. Three patients were operated including two women: one was re-operated by subcostal incision for peritonitis and two had undergone cholecystectomy without conversion. Surgical technique is detailed in the manuscript and the video. Laparoscopic repair was performed between 45 and 300 days after cholecystectomy. Surgery lasted between 250 and 270 min with no conversion and no transfusion. The postoperative course was uneventful with a hospital stay ranging from 7 to 9 days. After a mean follow-up of 9-33 months, patients were symptom free with normal liver function tests. The laparoscopic approach can be safely and effectively proposed to a subgroup of patients with BDI. This approach has the advantages of the laparoscopic approach and represents the main new surgical advancement in the management of this complication.
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France. safi.dokmak@bjn.aphp.fr.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France. safi.dokmak@bjn.aphp.fr.
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: Najat
authors.initials: N
authors.lastname: Amharar
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Aussilhou
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Cauchy
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris VII Denis Diderot, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D002763:Cholecystectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Bile duct injury; Cholecystectomy; Laparoscopic repair; Traumatism