Usefulness of both operative cholangiography and conversion to decrease major bile duct injuries during laparoscopic cholecystectomy

Journal of Hepato-biliary-pancreatic Surgery
Ezio CaratozzoloNicoló Bassi

Abstract

We evaluated the role of operative cholangiography and of conversion to decrease major bile duct injuries. We report 1074 patients who underwent laparoscopic cholecystectomy, out of a total of 1195 patients who underwent laparoscopy, over an 8-year period. The planned laparoscopic operative procedure in all the patients was the standard four-port technique with the operator on the left side of the patient. Operative cholangiography was performed with Olsen's pliers. We performed 993 (83%) operative cholangiographies; 121 (10.1%) patients were converted from laparoscopic to open cholecystectomy. Despite a prolonged time of dissection, 54 (4.5%) patients were converted because of unclear anatomy of Calot's triangle. One hundred and ninety patients suffered acute cholecystitis and, of those, 52 (27.3% of 190 patients) were converted. Fifteen patients showed intraoperative biliary duct stones and they were converted. Seven (0.58%) bile duct injuries (one stricture and six fistulas) are reported. The low number of major bile duct injuries reported in our study showed the value of operative cholangiography during laparoscopic cholecystectomy. Moreover, another important factor found to reduce major bile duct injuries was conversion w...Continue Reading

Citations

Oct 7, 2008·Journal of Hepato-biliary-pancreatic Surgery·Akira NiiHirofumi Kanemura
Oct 3, 2007·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Emmanouil ZacharakisDimitrios Betsis
Nov 28, 2012·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Antonio BresciaFrancesco Saverio Mari
May 15, 2015·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Dieuwertje A van DamWilhelmus J H J Meijerink
Oct 3, 2006·Journal of Hepato-biliary-pancreatic Surgery·Yuichi YamashitaKouichi Hirata
Nov 25, 2004·Journal of Surgical Oncology·Earl Gaar

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