Iatrogenic bile duct injury by using harmonic scalpel in laparoscopic cholecystectomy
10.3760/cma.j.issn.1007-631X.2009.01.009
- VernacularTitle:超声刀腹腔镜胆囊切除术胆管损伤的特点和处理
- Author:
Wensheng CAO
;
Hui CHEN
;
Aowen XIE
;
Xinjun WU
;
Qinqiao FAN
;
Jianhong NIE
;
Yi YU
- Publication Type:Journal Article
- Keywords:
Sonication;
Cholecystectomy,laparoscopic;
Bile duct injury
- From:
Chinese Journal of General Surgery
2009;24(1):23-25
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features and management of bile duct injury caused by laparoscopic cholecysteetomy by using harmonic scalpel (UHS-LC), and its prevention. Methods The clinical data of 1863 UHS-LC cases from April 2003 to February 2008 were retrospectively analyzed. There were 11 patients suffering from UHS-LC related iatrogenic bile duct injury including intraoperatively immediate recognized injuries in 9 cases, and postoperatively found injuries in 2 cases. For those patients in which bile duct injury was found during the UHS-LC procedure, the patient was converted to open surgery, the injury was repaired accordingly by end-to-end bile duet anastomosis or Roux-en-Y procedure. For the injuries found postoperatively (all two cases were of CBD perforation), CBD was sutured by second stage. Results All the 11 patients recovered well and no biliary stricture occurred during the follow up of 1-5 years. Conclusions While UHS-LC is suitable for most cases of choleeystectomy, it causes significant porcentage of bile duct injury (0. 6% ) in hands of unskillful surgeons. It is important to be on alert against iatrugenic bile duct injuries.
