Abstract
Dissection and transection of the cystic duct close to the gallbladder has been advocated as a means of avoiding common bile injury during laparoscopic cholecystectomy (LC). We present three cases in which inadequate identification of the gallbladder—cystic duct junction resulted in incomplete cholecystectomy. In two patients an unsecured gallbladder infundibulum presented as cystic duct leaks and one patient developed recurrent symptomatic cholelithiasis. These cases emphasize the need for complete dissection and visualization of the cystic duct at the gallbladder prior its division and secure ligation during LC.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387
Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME, Newman GE, Cotton PB, Meyers WC (1992) Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg 215(3): 196–202
Deziel D, Millikan KW, Economou S, Doolas A, Ko S, Airan M (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 165: 9–14
Goldin E, Katz E, Wengrower D, Kluger Y, Haskel L, Shiloni E, Libson E (1990) Treatment of fistulas of the biliary tract by endoscopic insertion of endoprostheses. Surg Gynecol Obstet 170: 418–423
Hunter JG (1991) Avoidance of bile duct injury during laparoscopic cholecystectomy. Am J Surg 162: 71–76
Kozarek RA, Traverso LW (1991) Endoscopic stent placement for cystic duct leak after laparoscopic cholecystectomy. Gastrointestinal Endoscopy 37(1): 71–73
Lepsien G, Ludtke FE, Neufang T, Schafmayer A, Peiper HJ (1991) Treatment of iatrogenic common bile duct injury during laparoscopic cholecystectomy through the laparoscopic insertion of a T-tube stent. Surg Endosc 5(3): 119–122
Meyers WC (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. N Eng J Med 324: 1073–1078
Moossa AR, Easter DW, Van Sonnenberg E, Casola G, D'Agostino H (1992) Laparoscopic injuries to the bile duct. A cause for concern. Ann Surg 215(3): 203–208
Peters JH, Gibbons GD, Innes JT, Nichols KE, Front ME, Roby SR, Ellison C (1991) Complications of laparoscopic cholecystectomy. Surgery 110: 769–778
Sackier JM, Berci G, Phillips E, Carroll B, Shapiro S, PazPartlow M (1991) The role of cholangiography in laparoscopic cholecystectomy. Arch Surg 126: 1021–1026
Sauerbruch T, Weinzierl M, Holl J, Pratschke E (1986) Treatment of postoperative bile fistulas by internal endoscopic biliary drainage. Gastroenterology 90: 1998–2003
Soa JL, Greenberg SS, Livingstone AS, Levi JU (1991) Laparoscopic ligation of a leaking cystic duct. J Laparoendosc Surg 1(4): 211–215
Way LW (1992) Bile duct injury during laparoscopic cholecystectomy. Ann Surg 215: 195
Wootton FT, Hoffman BJ, Marsh WH, Cunningham JT (1992) Biliary complications following laparoscopic cholecystectomy. Gastrointest Endosc 38(2): 183–185
Zucker KA, Bailey RW, Gadacz TR, Imbembo AL (1991) Laparoscopic guided cholecystectomy. Am J Surg 161: 36–44
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Walsh, R.M., Chung, R.S. & Grundfest-Broniatowski, S. Incomplete excision of the gallbladder during laparoscopic cholecystectomy. Surg Endosc 9, 67–70 (1995). https://doi.org/10.1007/BF00187890
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00187890