Relationship between the risk of bile duct injury during laparoscopic cholecystectomy and the types of preoperative magnetic resonance cholangiopancreatiocography (MRCP).
10.14701/kjhbps.2012.16.1.17
- Author:
Yun Ho CHUNG
1
;
Doo Jin KIM
;
In Gyu KIM
;
Han Jun KIM
;
Seong Eun CHON
;
Jang Yong JEON
;
Jae Pil JUNG
;
Jin Cheol JEONG
;
Joo Seop KIM
;
Eun Joo YUN
Author Information
1. Department of Surgery, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea. drkdj@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Bile duct;
Magnetic resonance cholangiopancreatiocography;
Cholecystectomy
- MeSH:
Bile;
Bile Ducts;
Cholecystectomy;
Cholecystectomy, Laparoscopic;
Humans;
Magnetic Resonance Spectroscopy;
Magnetics;
Magnets;
Retrospective Studies
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2012;16(1):17-23
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUNDS/AIMS: Bile duct injury is one of the potential severe complications that can occur during laparoscopic cholecystectomy, which can be cause by anatomic variations in the confluence of the bile duct. Recently magnetic resonance cholangiopancreatiocography (MRCP) has become a helpful tool to detect bile duct variation on a preoperative basis and to prevent bile duct injury during laparoscopic cholecystectomy, as well other hepatic surgeries. This study aimed to clarify the types of bile duct on MRCP and to search for a method of avoiding injury during laparoscopic cholecystectomy. METHODS: Between January 2009 and December 2010, 277 patients underwent laparoscopic cholecystectomy with preoperative MRCP in our institution. On a retrospective basis, the bile ducts were categorized into 5 types according to the Couinaud classification system. RESULTS: The proportion of types was revealed type A (70.4%), type B (8.7%), type C (19.5%), type D (0.7%), type E (0%), and type F (0.7%), respectively. Bile duct injury occurred in 4 cases (1.4%) during laparoscopic cholecystectomy. In particular, the possibility of aberrant extrahepatic confluence (Type C and F) represented the highest risk of duct injury (OR=11.89 [CI: 1.21-116.53]). CONCLUSIONS: Preoperative evaluation of the bile duct anatomy is important to avoid injury of duct during laparoscopic cholecystectomy. Specific types of bile duct variation should be considered as a high risk group for bile duct injury.
