Research Article


Bile duct injury in laparoscopic cholecystectomy with a posterior infundibular approach

,  ,  ,  ,  

1 Department of Visceral Surgery, University Hospitals KU Leuven, Herestraat 49, 3000 Leuven, Belgium

2 Department of Management Information & Reporting, University Hospitals KU Leuven, Herestraat 49, 3000 Leuven, Belgium

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Baki Topal

Herestraat 49, 3000 Leuven,

Belgium

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Article ID: 100100Z04MC2022

doi: 10.5348/100100Z04MC2022RA

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How to cite this article

Geers J, Jaekers J, Topal H, Collignon A, Topal B. Bile duct injury in laparoscopic cholecystectomy with a posterior infundibular approach. Int J Hepatobiliary Pancreat Dis 2022;12(2):5–13.

ABSTRACT


Aims: Bile duct injury (BDI) in laparoscopic cholecystectomy (LC) has a significant impact on morbidity and mortality. Although the critical view of safety (CVS) concept is the most widely supported approach to prevent BDI, alternative approaches are used as well. The aim was to evaluate the incidence, severity, and management of bile duct injury in LC, using a posterior infundibular approach.

Methods: This retrospective, monocentric cohort study includes patients who underwent LC for gallstone disease. Data were collected in a prospectively maintained database. Patients with BDI were identified and were analyzed in-depth.

Results: Between 1999 and 2018, 8389 consecutive patients were included (M/F 3288/5101; mean age 55 (standard deviation; SD ± 17) years). Mean length of postoperative hospital stay was two days (SD ± 4). Fourteen patients died after LC and 21 patients were identified with BDI. Seventeen BDI (81%) patients were managed minimally invasive (14 endoscopic, 3 laparoscopic), and 4 patients via laparotomy (3 hepaticojejunostomy, 1 primary suture). Severe complications (Clavien-Dindo ≥3) after BDI repair were observed in 6 patients. There was no BDI-related mortality. Median follow-up time was 113 months (range 5–238).

Conclusion: A posterior infundibular approach in LC was associated with a low incidence of BDI and no BDI-related mortality.

Keywords: Bile duct injury, Laparoscopic cholecystectomy, Surgical technique

SUPPORTING INFORMATION


Author Contributions

Joachim Geers - Acquisition of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Joris Jaekers - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published

Halit Topal - Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

André Collignon - Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published

Baki Topal - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2022 Joachim Geers et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.