Bile Duct Injury During Cholecystectomy: Necessity to Learn How to Do and Interpret Intraoperative Cholangiography

Frontiers in Medicine

article

Niki Christou¹  Sylvaine Durand-Fontanier¹  Denis Valleix¹  Muriel Mathonnet¹  Alexia Roux-David¹  David N. Naumann³  Stephane Bouvier¹  Thibaud Rivaille¹  Sophiane Derbal¹  Abdelkader Taibi¹  Anne Fabre¹  Fabien Fredon¹ 

[1] Department of Digestive Surgery, University Hospital of Limoges;Department of Visceral Surgery, Geneva University Hospitals and Medical School;Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, United Kingdom

关键词: intraoperative cholangiography;    interpretation;    cholecystectomy;    bile duct injury;    laparoscopy;   

DOI  :  10.3389/fmed.2021.637987

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Biliary duct injury (BDI) is a serious complication during cholecystectomy. Perioperative cholangiography (POC) has recently been generating interest in order to prevent BDI. However, the current literature (including randomized controlled trials) cannot conclude whether POC is protective or not against the risk of BDI. The aim of our study was to investigate whether POC could demonstrate earlier BDI and which criteria are required to make that diagnosis. Methods: We performed a retrospective study between 2005 and 2018 in our French tertiary referral center, which included all patients who had presented following BDI during cholecystectomy. Results: Twenty-two patients were included. Nine patients had POC, whereas 13 did not. When executed, POC was interpreted as normal for three patients and abnormal for six. In this latter group, only two cases had a BDI diagnosed intraoperatively. In other cases, the interpretation was not adequate. Conclusion: BDIs are rare but may reduce patients' quality of life. Our study highlights the surgeon's responsibility to learn how to perform and interpret POC in order to diagnose and manage BDIs and potentially avoid catastrophic consequences.

【 授权许可】

CC BY