Iatrogenic biliary injuries: identification, classification, and management

Surg Clin North Am. 2014 Apr;94(2):297-310. doi: 10.1016/j.suc.2014.01.008.

Abstract

Because it offers several advantages over open cholecystectomy, laparoscopic cholecystectomy has largely replaced open cholecystectomy for the management of symptomatic gallstone disease. The only potential disadvantage is a higher incidence of major bile duct injury. Although prevention of these biliary injuries is ideal, when they do occur, early identification and appropriate treatment are critical to improving the outcomes of patients suffering a major bile duct injury. This report delineates the key factors in classification (and its relationship to mechanism and management), identification (intraoperative and postoperative), and management principles of these bile duct injuries.

Keywords: Bile duct injury; Biliary stricture; Biliary-enteric anastomosis; Laparoscopic cholecystectomy; Management.

Publication types

  • Review

MeSH terms

  • Biliary Tract / injuries*
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Humans
  • Intraoperative Complications / classification
  • Intraoperative Complications / diagnosis
  • Intraoperative Complications / surgery
  • Postoperative Complications / classification
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery
  • Reoperation
  • Time-to-Treatment
  • Vascular System Injuries / classification
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / surgery