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Chirurgia 2011 August;24(4):197-9

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Common bile duct injury during laparoscopic cholecystectomy: our experience

Portale T., Minutolo V., Li Destri G., Trovato M. A., Pesce A., Puleo S.

Department of Surgical Sciences. Organ Transplants and Advanced Technologies. University of Catania, Catania, Italy


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Aim. Iatrogenic injuries of the bile ducts during laparoscopic cholecystectomy represent an important problem in consideration of the gravity, the inherent difficulties of surgical treatment of the lesions and the costs, resulting object of frequent medico-legal contentious. The incidence of major biliary duct injury ranges from 0.25% to 0.74%, and of minor injury from 0.28% to 1.7%. Scopo dello studio era verificare la frequenza delle lesioni del dotto biliare durante la colicistectomia laparoscopica.
Methods. We have reviewed data of 1060 patients undergoing laparoscopic cholecystectomy from January 2003 to November 2009, 708 female and 352 men; 33 patients (3.11%) needed conversion to open cholecystectomy, 150 was performed by 2 teams during learning curve, 910 by teams with over 10 years of experience. Were used two methods of pneumo-peritoneum by Verres in 299 cases and by Hasson in 761. French technique was used in 386 cases and American technique in 674.
Results. Only 1 common bile duct injury (0.9%), and 3 duct leaks (0.29%) were detected among these. One Luschka duct leaks and 2 cystic duct leaks, 1 of these needed of surgical treatment occurred in 1060 consecutive laparoscopic cholecystectomy. No postoperative death due to laparoscopic cholecystectomy occurred.
Conclusion. Preoperative evaluation of clinical risk factors, intraoperative caution, instrumental evaluation and conversion must be taken into consideration when needed.

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