Trends in Bile Duct Injuries from Laparoscopic Cholecystectomy

被引：48

作者：

Walsh R.M. ^{[1
,2
]}

Henderson J.M. ^{[1
]}

Vogt D.P. ^{[1
]}

Mayes J.T. ^{[1
]}

Grundfest-Broniatowski S. ^{[1
]}

Gagner M. ^{[1
]}

Ponsky J.L. ^{[1
]}

Hermann R.E. ^{[1
]}

机构：

[1] Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH

[2] Cleveland Clinic Foundation, Department of General Surgery, Cleveland, OH 44195

来源：

Journal of Gastrointestinal Surgery | 1998年 / 2卷 / 5期

关键词：

Bile Duct; Bismuth; Chole; Bile Duct Injury; Duct Leak;

D O I：

10.1016/S1091-255X(98)80037-1

中图分类号：

学科分类号：

摘要：

Bile duct injuries are a serious complication of cholecystectomy Laparoscopic cholecystectomies (LC) were originally associated with an increased incidence of injuries Patients referred to a tertiary center were reviewed to assess the trends in the number, presentation, and management Seventy-three patients were referred over a 6-year period with a maximum of 17 patients referred in 1992, but the number has not declined substantially over time The persistent number of referrals is a consequence of ongoing injuries One third of injuries were diagnosed at LC, and the use of cholangiography has not increased The number of cystic duct leaks has not decreased and they represent 25% of all cases The level of injury has remained unchanged with Bismuth types I and II in 37% and types III and IV in 38% Excluding patients with cystic duct leaks, 58% were referred after a failed ductal repair Definitive treatment with biliary stenting was successful in 37%, and 34 patients (47%) required a biliary-enteric anastomosis Complications occurred in 18 patients (25%) including seven with postoperative stricture or cholangitis No biliary reoperations have been performed at a mean follow-up of 36 months.

引用

页码：458 / 462

页数：4

共 22 条

[1]

Reddick E.J., Olsen D.O., Laparoscopic laser cholecystectomy: A comparison with mini-lap cholecystectomy, Surg Endosc, 3, pp. 131-133, (1989)

[2]

Spaw A.T., Reddrick E.J., Olsen D.O., Laparoscopic laser cholecystectomy: Analysis of 500 procedures, Surg Laparosc Endosc, 1, pp. 2-7, (1991)

[3]

Schirmer B.D., Edge S.B., Dix J., Hyser M.J., Hanks J.B., Jones R.S., Laparoscopic cholecystectomy - Treatment of choice for symptomatic cholelithiasis, Ann Surg, 213, pp. 665-677, (1991)

[4]

Gallstones and Laparoscopic Cholecystectomy, NIH Consensus Statement, 10, 3, pp. 1-26, (1992)

[5]

Pickleman J., Gonzalez R.P., The improving results of cholecystectomy, Arch Surg, 121, pp. 930-934, (1986)

[6]

Ganey J.B., Johnson P.A., Prillaman P.E., McSwain G.R., Cholecystectomy Clinical experience with a large series, Am J Surg, 151, pp. 352-357, (1986)

[7]

Matthews J.B., Blumgart L.H., Benign biliary strictures, Surgery of the Liver and Biliary Tract, (1994)

[8]

Woods M.S., Traverso L.W., Kozarek R.A., Donohue J.H., Fletcher D.R., Hunter J.G., Oddsdottir M., Rossi R.L., Tsao J., Windsor J., Biliary tract complications of laparoscopic cholecystectomy are detected more frequently with routine intraoperative cholangiography, Surg Endosc, 9, pp. 1076-1080, (1995)

[9]

Russell J.C., Walsh S.J., Mattie A.S., Lynch J.T., Bile duct injuries, 1989-1993: A statewide experience, Arch Surg, 131, pp. 382-388, (1996)

[10]

Richardson M.C., Bell G., Fullarton G.M., Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: An audit of 5913 cases, Br J Surg, 83, pp. 1356-1360, (1996)

← 1 2 3 →