Laparoscopic end-to-end biliary reconstruction with T-tube for transected bile duct injury during laparoscopic cholecystectomy

Bong Jun Kwak; Ho Joong Choi; Young Kyoung You; Dong Goo Kim; Tae Ho Hong

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저자정보: Bong Jun Kwak (The Catholic University of Korea) Ho Joong Choi (The Catholic University of Korea) Young Kyoung You (The Catholic University of Korea) Dong Goo Kim (The Catholic University of Korea) Tae Ho Hong (The Catholic University of Korea)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.96 No.6

발행연도: 2019.6

수록면: 319 - 325 (7page)

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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.

#Bile duct injury #Laparoscopy #Cholecystectomy #T-tube

참고문헌 (10)

참고문헌 신청

Adamsen S / 1997 / Bile duct injury during laparoscopic cholecystectomy : a prospective nationwide series / J Am Coll Surg 184:571~578

Strasberg SM / 1995 / An analysis of the problem of biliary injury during laparoscopic cholecystectomy / J Am Coll Surg 180:101~125

Hamad MA / 2011 / Major biliary complications in 2, 714 cases of laparoscopic cholecystectomy without intraoperative cholangiography : a multicenter retrospective study / Surg Endosc 25:3747~3751

Gigot J / 1997 / The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients / Surg Endosc 11:1171~1178

Jablonska B / 2009 / Hepaticojejunostomy vs. end-to-end biliary reconstructions in the treatment of iatrogenic bile duct injuries / J Gastrointest Surg 13:1084~1093

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