World Journal of Laparoscopic Surgery

Register      Login

VOLUME 3 , ISSUE 1 ( January-April, 2010 ) > List of Articles

RESEARCH ARTICLE

Bile Duct Injury in Laparoscopic Cholecystectomy without On-table Cholangiography

Rooh-ul-Muqim, Aziz Wazir, Mohammad Zarin, Mujeeb-Ur-Rehman, Shehzad Akbar, Usra Ahmed, Muhammad Salman

Citation Information : Rooh-ul-Muqim, Wazir A, Zarin M, Mujeeb-Ur-Rehman, Akbar S, Ahmed U, Salman M. Bile Duct Injury in Laparoscopic Cholecystectomy without On-table Cholangiography. World J Lap Surg 2010; 3 (1):41-44.

DOI: 10.5005/jp-journals-10007-1080

Published Online: 01-08-2012

Copyright Statement:  Copyright © 2010; The Author(s).


Abstract

Objective

To determine the safety of laparoscopic cholecystectomy without On-table cholangiography.

Study design

Quasi-experimental study.

Setting and duration

Surgical “D” ward Khyber teaching hospital Peshawar from January 2005 to December 2008.

Methodology

Patients of acute or chronic cholecystitis due to gallstones were included in this study while patients of obstructive jaundice and gallbladder mass were excluded. All patients were operated through laparoscopic cholecystectomy without On-table cholangiography. During procedure, bile duct injury were noted and evidences of bile duct injury were also collected postoperatively during hospitalization and follow-up visits. Data regarding complications in terms of bile duct injury were recorded and analyzed.

Results

A total of 7 (0.92%) bile duct injuries were noted in this series. There were two (0.26%) cases of partial injury to the common hepatic duct out of which 1 was a case of Mirizzi's syndrome. In the second case, a partial injury to the common hepatic duct occurred during an attempt to cauterize the avulse branch of cystic artery. In two (0.26%) patient's partial injury to common bile duct occurred due to tenting of common bile duct. Complete transaction of common bile duct occurred in two (0.26%) cases. In one (0.13%) patient postoperative leakage was found to be due to severed cholecystohepatic duct.

Conclusion

The results clearly show that there is hardly any difference as far as the CBD injury is concerned with or without On-table cholangiography, provided we have a good back-up by a radiologist for pre- and postoperative ultrasound and ERCP.


PDF Share
  1. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg 1992;215:196-202.
  2. Laparoscopic injuries to the bile duct: A cause for concern. Ann Surg 1992;215:203-08.
  3. Routine cholangiography reduces sequelae of common bile duct injuries. Surg Endosc 1996;10:1194-97.
  4. Operative cholangiography. Surg Gynecol Obstet 1937;65:702-10.
  5. Management of choledocholithiasis. Ann Surg 1972;176:347-59.
  6. Intraoperative cholangiography during laparoscopic cholecystectomy. Surg Endosc 2000;14:1118-22.
  7. Safe laparoscopic cholecystectomy without intraoperative cholangiography. Surg Laparosc Endosc 1993;3:17-20.
  8. Common bile duct evaluation in the era of laparoscopic cholecystectomy: 1050 cases later. Ann Surg 1994;219:744-52.
  9. A comparison of intraoperative ultrasound versus cholangiography in the evaluation of the common bile duct during laparoscopic cholecystectomy. Surg Endosc 1995;9:490-96.
  10. Intraoperative cholangiography during laparoscopic cholecystectomy. Routine vs selective policy. Surg Endosc 1994;8:302-05.
  11. Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injuries during laparoscopic cholecystectomy. Br J Surg 1996;83:171-75.
  12. Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg 1995;82:307-13.
  13. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 1991;324:1073-78.
  14. Continuing hazards of the learning curve in laparoscopic cholecystectomy. Am Surg 1995;61:914-18.
  15. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. JACS 1995;180:101-25.
  16. Common bile duct injuries during laparoscopic cholecystectomy.
  17. Avoidance of bile duct injury during laparoscopic cholecystectomy. Am J Surg 1991;162:71-76.
  18. NIH Consensus Statement 1992 Sept 14-16:10(3):1-26.
  19. Bile duct injury after laparoscopic cholecystectomy. Surg Endosc 1998;12:315-21.
  20. Bile duct injury during laparoscopic cholecystectomy: Myth or reality of the learning curve? Surg Endosc 2000;14:608-11.
  21. Bile Duct Injury During Laparoscopic Cholecystectomy: Results of a National Survey. Ann Surg 2001;234(4):549-59.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.