Central Surgical AssociationLong-term results of surgical repair of bile duct injuries following laparoscopic cholecystectomy*,**
Section snippets
Patient population and treatment
A retrospective analysis was performed on all patients referred to the hepatobiliary surgical service at the University of Cincinnati Medical Center from Aug 1, 1991 through Dec 1, 1999 (Figure).During this period, 27 patients were referred after major LC-related injuries to the biliary tree and formed the basis for this report. The charts were reviewed and data recorded on: demographic information, date of LC, type of injury, surgical,
Presentation and management before referral
There were 27 patients (24 female, 3 male) with a mean age of 45.3 ± 3.3 years (range, 16-78 years). The mean time to referral from the original LC was 348.4 ± 104.2 days (range, 0 to 2323 days). The mean time to definitive surgical repair was 359.9 ± 118.0 days (range, 0 to 2331 days) (Table I).Type of injury Time to referral (d) Time to surgery (d) A 5 — C 10 — 15 — 138 296 E1 12 19 15 24 48 54 86 221 167 173 303 315 461 520 667 680 705 712 1089 1107 E2 0 0 4 22 5 39 988
Discussion
The occurrence of biliary injuries after LC and their management algorithm has been well described in the literature. 1, 2, 5, 8, 11 The incidence of major biliary injuries after LC is about 0.2% to 0.8% and appears to represent a significant increase over conventional cholecystectomy. 1, 2, 5, 9, 12 The literature describes several risk factors for the occurrence of these injuries and includes poor visualization of the operative field, aberrant anatomy, surgeon experience, acute and or chronic
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Cited by (0)
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Reprint requests: Douglas W. Hanto, MD, PhD, University of Cincinnati College of Medicine, Department of Surgery, Division of Transplantation, 231 Bethesda Ave, Cincinnati, OH 45267-0558.
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Surgery 2000;128:668-77