Presidio Ospedaliero Santa Maria Incoronata dell’Olmo di Cava de’ Tirreni, Azienda Ospedaliera Integrata con l’Università, Via de Marinis, 84131 Cava dei Tirreni, Italy
Roberto Troisi
Clinical Medicine and Surgery Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
Vincenzo Pilone
Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a bile leak from an LD. A total of 136 articles were retrieved from the searched databases. After the removal of duplicates and non-eligible papers, 48 studies reporting 231 leaks were included: 20 (41.6%) case reports, 2 (4.3%) comparative studies, 7 (14.9%) meeting abstracts and 19 (40.4%) retrospective cohort articles. The rate of LD leak ranges from 0.05% to 1.9%, but injury to a duct of Luschka was the second most common cause of biliary leakage in all the cohort studies (5.5% to 41%). In 21 (43.7%) cases, the leak was successfully treated with a sphincterotomy through Endoscopic Retrograde Cholangiopancreatography (ERCP) plus or minus stenting, and in 12 (25%), re-laparoscopy was necessary.
