Laparoscopic end-to-end biliary reconstruction with T-tube for transected bile duct injury during laparoscopic cholecystectomy
10.4174/astr.2019.96.6.319
- Author:
Bong Jun KWAK
1
;
Ho Joong CHOI
;
Young Kyoung YOU
;
Dong Goo KIM
;
Tae Ho HONG
Author Information
1. Department of Hepatobiliary and Pancreas Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. gshth@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Bile duct injury;
Laparoscopy;
Cholecystectomy;
T-tube
- MeSH:
Bile Ducts;
Bile;
Cholecystectomy;
Cholecystectomy, Laparoscopic;
Classification;
Common Bile Duct;
Constriction, Pathologic;
Female;
Follow-Up Studies;
Humans;
Laparoscopy;
Length of Stay;
Male;
Postoperative Complications;
Reoperation;
Retrospective Studies
- From:Annals of Surgical Treatment and Research
2019;96(6):319-325
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This report describes the laparoscopic end-to-end biliary reconstruction with T-tube for transected bile duct injury (BDI) during laparoscopic cholecystectomy. METHODS: We performed a retrospective descriptive analysis for all patients with a transected BDI at a single institution. We collected and analyzed data for injury site and type, reconstruction methods, conversion rate, previous intervention, and outcomes. RESULTS: Between January 2014 and December 2017, 2,901 patients underwent laparoscopic cholecystectomy at a single institution. Among them, 8 patients experienced a transected BDI during laparoscopic cholecystectomy, so the surgeon performed laparoscopic end-to-end biliary reconstruction with T-tube. Our patient series consisted of 6 women (75%) and 2 men (25%) with a mean age of 48.3 years (median, 49 years; range, 29–77 years). Two cases were converted to open surgery. The most common injured site was the common bile duct (5 of 8, 62.5%). The most common injury type, using Bismuth's classification system, was type I (3 of 8, 37.5%). The mean operating time was 136.8 minutes (median, 135.0 minutes; range, 0–180.0 minutes). The mean hospital stay was 7.0 days (median, 4.5 days, range: 3.0–21.0 days). The mean follow-up was 36.4 months (median, 34.0 months; range, 16.0–63.0 months). We observed one postoperative complication during the follow-up period. The patient had an anastomosis site leakage and was cured after reoperation. CONCLUSION: Laparoscopic end-to-end biliary reconstruction with T-tube for transected BDI during laparoscopic cholecystectomy seems to be safe and feasible in selected patients. However, long-term follow-up to identify complications from bile duct stricture remains important.
