Sunil Seth Associate Professor, Department of Radiodiagnosis, Punjab Institute of Medical Sciences, Jalandhar 144001, India
Yatin Gosh Professor and Head, Department of General Surgery,Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India
Ankur Hastir Associate Professor, Department of General Surgery,Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India
Shivani null Junior Resident, Department of General Surgery, Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India
Address for correspondence: Sunil Seth, Associate Professor, Department of Radiodiagnosis, Punjab Institute of Medical Sciences, Jalandhar 144001, India E-mail: sunilseth@yahoo.com
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
Yatin Gosh, Sunil Seth et. al./Early Detection of Common Bile Duct Injury Post Cholecystectomy, What are the Options?/New Indian J Surg. 2022;13(4): 161–165.
Timeline
Received : April 05, 2022
Accepted : May 15, 2022
Published : December 25, 2022
Abstract
In the present scenario, laparoscopic cholecystectomy remains the most common surgery performed by the general surgeons but there is constant fear of the common bile duct injury associated with it. We have moved from the era of open to laparoscopic cholecystectomy with a long initial learning curve for the surgeons.2,3 During this period, the most vulnerable structure to injury is common bile duct1,4 which can lead to serious complications like biliary peritonitis, hepatic failure and death. 22 Majority of the patients are identified later with progression of jaundice and a few are recognized on table requiring immediate repair. Our study is focused on the role of ultrasound in the postoperative period as a tool for detecting common bile duct injury within 72 hours of cholecystectomy.
Key message: The incidence of CBD injury may be rising with Increasing trend of laparoscopic cholecystectomy. Early recognition is the key of management of CBD injury. MRCP is the gold standard investigation for bile duct injuries. Ultrasound is of immense significance in resource poor settings where the MRCP, CT are not available.
References
1. Deziel DJ, Millikan KW, Economou SG, et al. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 1993; 165: 9–14. [PubMed]
2. Hunter JG, Sackier JM, Berci G. Training laparoscopic cholecystectomy: quantifying the learning curve. Surg Endosc 1994; 8: 28– 31. [PubMed]
3. Hunter JG. The learning curve in laparoscopic cholecystectomy. Minimally Invasive Therapy & Allied Technologies 1997; 6: 24–25.
4. A prospective analysis of 1518 laparoscopic cholecystectomies. The Southern Surgeons Club. N Engl J Med 1991; 324:1073–1078. [PubMed]
5. Vecchio R, MacFayden BV, Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000 Mar; 42(1):87-90. PMID: 11019611.
6. Andrzej Smereczyński, Teresa Starzyńska, Katarzyna Kołaczyk. Role of sonography in assessing complications after laparoscopic cholecystectomy. Journal of Ultrasonography 2014; 14: 152–162.
7. Walker Reynolds.Journal of the Society of Laparoendoscopic Surgeons. JSLS (2001)5:89- 94.
8. Adamsen S, Hansen OH, Funch-Jensen P, et al. Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series. J Am Coll Surg 1997; 184: 571–578. [PubMed]
9. Merrie AE, Booth MW, Shah A, et al. Bile duct imaging and injury: a regional audit of laparoscopic cholecystectomy. Aust NZ J Surg 1997; 67: 706–711. [PubMed]
10. Legorreta AP, Silber JH, Costantino GN, et al. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy. JAMA 1993; 270: 1429–1432. [PubMed]
11. Shea JA, Berlin JA, Bachwich DR, et al. Indications for outcomes of cholecystectomy: a comparison of the pre and postlaparoscopic eras. Ann Surg 1998; 227: 343–350. [PMC free article] [PubMed]
12. Goodman GR, Hunter JG. Laparoscopic cholecystectomy: results from a university hospital. Am J Surg 1991; 162: 576–579. [PubMed]
14. Thurley PD, Dhingsa R. Laparoscopic cholecystectomy: postoperative imaging. AJR Am J Roentgenol. 2008; 191:794–801. [PubMed]
15. Pesce A, Palmucci S, La Greca G, Puleo S. Iatrogenic bile duct injury: impact and management challenges. Clin Exp Gastroenterol. 2019;12: 121-128. Published 2019 Mar 6. doi: 10.2147/CEG.
16. Tzovaras G, Dervenis C: Vascular Injuries in Laparoscopic Cholecystectomy: An Underestimated Problem. Dig Surg 2006;23:370-374. doi: 10.1159/000097951.
17. Viera, F.T., Armellini, E., Rosa, L. et al. Abdominal spilled stones: ultrasound findings. Abdom Imaging 31, 564–567 (2006). https://doi.org/10.1007/s00261-005-0241-8.
18. Brockmann JG, Kocher T, Senninger NJ, Schurmann GM. Complications due to gallstones lost during laparoscopic cholecystectomy. Surg Endosc. 2002;16:1226– 1232. [PubMed]
19. Woodfield JC, Rodgers M, Windsor JA. Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management. Surg Endosc. 2004;18:1200– 1207. [PubMed]
20. Bemporad JA, Zreik TG, Brink JA. Laparoscopic hernias: two case reports and a review of the literature. J Comput Assist Tomogr. 1999;23:86–89. [PubMed]
21. Abhinandan Goswami, Mituban Gogoi, Mustafa Abdur Rahman. A study on biliary leakage after cholecystectomy. International Journal of Contemporary Medical Research 2017; 4 (5):1212-1215.
22. Buell JF, Cronin DC, Funaki B, et al. Devastating and Fatal Complications Associated With Combined Vascular and Bile Duct Injuries During Cholecystectomy. Arch Surg. 2002;137 (6):703–710.
23. Renz B, W, Bösch F, Angele M, K: Bile Duct Injury after Cholecystectomy: Surgical Therapy. Visc Med 2017;33:184-190. doi: 10.1159/000471818.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Yatin Gosh, Sunil Seth et. al./Early Detection of Common Bile Duct Injury Post Cholecystectomy, What are the Options?/New Indian J Surg. 2022;13(4): 161–165.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.