Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008;10(1):4-12.
doi: 10.1080/13651820701883114.

Complex bile duct injuries: management

E de Santibáñes  1 , V Ardiles, J Pekolj
Affiliations

Complex bile duct injuries: management

E de Santibáñes et al. HPB (Oxford). 2008.

Abstract

Laparoscopic cholecystectomy is the present treatment of choice for patients with gallbladder stones, despite its being associated with a higher incidence of biliary injuries compared with the open procedure. Injuries occurring during the laparoscopic approach seem to be more complex. A complex biliary injury is a disease that is difficult to diagnose and treat. We considered complex injuries: 1) injuries that involve the confluence; 2) injuries in which repair attempts have failed; 3) any bile duct injury associated with a vascular injury; 4) or any biliary injury in association with portal hypertension or secondary biliary cirrhosis. The present review is an evaluation of our experience in the treatment of these complex biliary injuries and an analysis of the international literature on the management of patients.

Keywords: Associated biliary lesions; complex bile duct injuries; liver transplantation for bile duct injuries.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Algorithm for the management of intraoperative diagnosed biliary injuries.
Figure 2.
Figure 2.
Associated vascular injury. A. CT scan with hipodense right liver lobe. B. Angiography with injury of right hepatic artery and right portal branch.
Figure 3.
Figure 3.
Management of Strasberg types B and C biliary injuries.
Figure 4.
Figure 4.
Intrahepatic multiple stenosis in right bile duct. A. CMRI with stenosis. B. CT scan after right hepatectomy.
Figure 5.
Figure 5.
Algorithm for the management of postoperative diagnosed biliary stenosis.
See this image and copyright information in PMC

References

    1. Cuschieri A, Dubois F, Mauriel J, Houser P, Becker H, Bues G. The European experience with laparoscopic cholecystectomy. Am J Surg. 1991;161:385–7. - PubMed
    1. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101–5. - PubMed
    1. Fletcher DR, Hobbs MST, Tan P. Complications of cholecystectomy bile duct injuries: risks of the laparoscopic approach and prospective effects of operative cholangiography. A population-based study. Ann Surg. 1999;229:449–57. - PMC - PubMed
    1. Lillemoe KD, Melton GB, Cameron JL, Pitt HA, Cambell KA, Talamini MA, et al. Postoperative bile duct strictures: management and outcome in the 1990s. Ann Surg. 2000;232:430–41. - PMC - PubMed
    1. Shah SR, Mirza DF, Afonso R, Mayer AD, McMaster P, Buckels JAC. Changing referral pattern of biliary injuries sustained during laparoscopic cholecystectomy. Br J Surg. 2000;87:890–1. - PubMed

LinkOut - more resources