Bile Duct Injury During Laparoscopic Cholecystectomy - a Preventable Issue?

Jennifer Knight
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引用次数: 1

Abstract

Laparoscopic cholecystectomies (LCs) are the current gold standard treatment for gallstone disease.  However, iatrogenic bile duct injury (IBDI) is a well-documented complication that significantly raises morbidity, mortality, length of hospitalisation, and financial costs.  With the popularisation of LCs in the 1990s the incidence of IBDIs went up from 0.1-0.5% in open procedures to 3% in LCs.  With an increasing amount of surgical experience, academic literature, and widespread recognition of the issue, the prevalence of IBDIs in the modern era is falling but they still occur with serious consequences.  This report presents a case of an elective LC with iatrogenic common bile duct (CBD) injury that was repaired with a Roux-en-Y hepaticojejunostomy that was later complicated by anastomotic leak and sepsis.  It will go on to review the evidence addressing why this happens and how best to prevent it, before briefly touching on management and associated complications.
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腹腔镜胆囊切除术中胆管损伤-一个可预防的问题?
腹腔镜胆囊切除术(lc)是目前治疗胆结石疾病的金标准。然而,医源性胆管损伤(IBDI)是一种有充分记载的并发症,可显著提高发病率、死亡率、住院时间和经济成本。随着20世纪90年代LCs的普及,ibdi的发病率从开放手术的0.1-0.5%上升到LCs的3%。随着越来越多的手术经验、学术文献和对这一问题的广泛认识,ibdi在现代的患病率正在下降,但它们仍然会带来严重的后果。本报告报告一例选择性LC合并医源性胆总管(CBD)损伤,采用Roux-en-Y肝空肠吻合术修复,后并发吻合口漏和败血症。在简要介绍管理和相关并发症之前,将继续回顾有关发生这种情况的原因和如何最好地预防它的证据。
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