ORIGINAL ARTICLES   

Chirurgia 2002 February;15(1):1-4

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Bile duct injury during laparoscopic cholecystectomy

Allocca A., Mazzetti P. M., Lulli R.

Background. Despite a widespread acceptance of laparoscopic cholecystectomy as the treatment of choice for cholelithiasis, concern has been expressed regarding the increase in biliary tract injuries (BTI) associated with this procedure. Four different types of injuries have been classified and only 31-58% of them can be identified during the intervention, while the remaining injuries occur within an average time interval of 7 days.
The aim of this retrospective study was to assessing the number and kinds of biliary truck injuries and to record their short and long term effects.
Methods. Since 1991 we have performed 1100 laparoscopic cholecystectomy for acute or chronic lithiasis of the gall bladder and/or common bile duct.
Results. Three cases out of 1100 (0.27%) interventions performed presented BTI.
Conclusions. A good knowledge of the mechanisms of injury, of the risk factors and an accurate surgical technique are important in the prevention of BTI. Anatomy must always be identified with precision also with the more frequent use of cholangiography during intervention. The results are determined by the type, level and extent of the injury and by the timeliness, type and adequacy of the initial treatment. Therefore we can confirm that the complications of laparoscopic cholecystectomy are the same as those of the traditional (open) technique.