World Journal of Emergency Surgery (Jun 2021)
2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy
- Nicola de’Angelis,
- Fausto Catena,
- Riccardo Memeo,
- Federico Coccolini,
- Aleix Martínez-Pérez,
- Oreste M. Romeo,
- Belinda De Simone,
- Salomone Di Saverio,
- Raffaele Brustia,
- Rami Rhaiem,
- Tullio Piardi,
- Maria Conticchio,
- Francesco Marchegiani,
- Nassiba Beghdadi,
- Fikri M. Abu-Zidan,
- Ruslan Alikhanov,
- Marc-Antoine Allard,
- Niccolò Allievi,
- Giuliana Amaddeo,
- Luca Ansaloni,
- Roland Andersson,
- Enrico Andolfi,
- Mohammad Azfar,
- Miklosh Bala,
- Amine Benkabbou,
- Offir Ben-Ishay,
- Giorgio Bianchi,
- Walter L. Biffl,
- Francesco Brunetti,
- Maria Clotilde Carra,
- Daniel Casanova,
- Valerio Celentano,
- Marco Ceresoli,
- Osvaldo Chiara,
- Stefania Cimbanassi,
- Roberto Bini,
- Raul Coimbra,
- Gian Luigi de’Angelis,
- Francesco Decembrino,
- Andrea De Palma,
- Philip R. de Reuver,
- Carlos Domingo,
- Christian Cotsoglou,
- Alessandro Ferrero,
- Gustavo P. Fraga,
- Federica Gaiani,
- Federico Gheza,
- Angela Gurrado,
- Ewen Harrison,
- Angel Henriquez,
- Stefan Hofmeyr,
- Roberta Iadarola,
- Jeffry L. Kashuk,
- Reza Kianmanesh,
- Andrew W. Kirkpatrick,
- Yoram Kluger,
- Filippo Landi,
- Serena Langella,
- Real Lapointe,
- Bertrand Le Roy,
- Alain Luciani,
- Fernando Machado,
- Umberto Maggi,
- Ronald V. Maier,
- Alain Chichom Mefire,
- Kazuhiro Hiramatsu,
- Carlos Ordoñez,
- Franca Patrizi,
- Manuel Planells,
- Andrew B. Peitzman,
- Juan Pekolj,
- Fabiano Perdigao,
- Bruno M. Pereira,
- Patrick Pessaux,
- Michele Pisano,
- Juan Carlos Puyana,
- Sandro Rizoli,
- Luca Portigliotti,
- Raffaele Romito,
- Boris Sakakushev,
- Behnam Sanei,
- Olivier Scatton,
- Mario Serradilla-Martin,
- Anne-Sophie Schneck,
- Mohammed Lamine Sissoko,
- Iradj Sobhani,
- Richard P. ten Broek,
- Mario Testini,
- Roberto Valinas,
- Giorgos Veloudis,
- Giulio Cesare Vitali,
- Dieter Weber,
- Luigi Zorcolo,
- Felice Giuliante,
- Paschalis Gavriilidis,
- David Fuks,
- Daniele Sommacale
Affiliations
- Nicola de’Angelis
- Unit of Minimally Invasive and Robotic Digestive Surgery, General Regional Hospital “F. Miulli”
- Fausto Catena
- Department of Emergency and Trauma Surgery of the University Hospital of Parma
- Riccardo Memeo
- Department of Hepato-Pancreatic-Biliary Surgery, General Regional Hospital “F. Miulli”
- Federico Coccolini
- General, Emergency and Trauma Department, Pisa University Hospital
- Aleix Martínez-Pérez
- Department of General and Digestive Surgery, Hospital Universitario Doctor Peset
- Oreste M. Romeo
- Trauma, Burn, and Surgical Care Program, Bronson Methodist Hospital
- Belinda De Simone
- Service de Chirurgie Générale, Digestive, et Métabolique, Centre hospitalier de Poissy/Saint Germain en Laye
- Salomone Di Saverio
- Department of Surgery, Cambridge University Hospital, NHS Foundation Trust
- Raffaele Brustia
- Unit of Digestive, Hepatobiliary and Pancreatic Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), and Faculty of Medicine, University of Paris Est, UPEC
- Rami Rhaiem
- Department of HBP and Digestive Oncologic Surgery, Robert Debré University Hospital
- Tullio Piardi
- Department of HBP and Digestive Oncologic Surgery, Robert Debré University Hospital
- Maria Conticchio
- Department of Hepato-Pancreatic-Biliary Surgery, General Regional Hospital “F. Miulli”
- Francesco Marchegiani
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua
- Nassiba Beghdadi
- Unit of Digestive, Hepatobiliary and Pancreatic Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), and Faculty of Medicine, University of Paris Est, UPEC
- Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University
- Ruslan Alikhanov
- Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center
- Marc-Antoine Allard
- Centre Hepatobiliaire, Paul Brousse Hospital
- Niccolò Allievi
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII
- Giuliana Amaddeo
- Service d’Hepatologie, APHP, Henri Mondor University Hospital, Creteil, and Faculty of Medicine, University of Paris Est, UPEC
- Luca Ansaloni
- General Surgery, San Matteo University Hospital
- Roland Andersson
- Department of Surgery, Linkonping University
- Enrico Andolfi
- Department of Surgery, Division of General Surgery, San Donato Hospital
- Mohammad Azfar
- Department of Surgery, Al Rahba Hospital
- Miklosh Bala
- Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center
- Amine Benkabbou
- Surgical Oncology Department, National Institute of Oncology, Mohammed V University in Rabat
- Offir Ben-Ishay
- Department of General Surgery, Rambam Healthcare Campus
- Giorgio Bianchi
- Unit of Minimally Invasive and Robotic Digestive Surgery, General Regional Hospital “F. Miulli”
- Walter L. Biffl
- Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla
- Francesco Brunetti
- Unit of Digestive, Hepatobiliary and Pancreatic Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), and Faculty of Medicine, University of Paris Est, UPEC
- Maria Clotilde Carra
- Rothschild Hospital, AP-HP, Paris, and Université de Paris
- Daniel Casanova
- Hospital Universitario Marqués de Valdecilla, University of Cantabria
- Valerio Celentano
- Colorectal Unit, Chelsea and Westminster Hospital, NHS Foundation Trust
- Marco Ceresoli
- Emergency and General Surgery Department, University of Milan Bicocca
- Osvaldo Chiara
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano
- Stefania Cimbanassi
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano
- Roberto Bini
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano
- Raul Coimbra
- Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center – CECORC and Loma Linda University School of Medicine
- Gian Luigi de’Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma
- Francesco Decembrino
- Gastroenterology and Endoscopy Unit, General Regional Hospital “F. Miulli”
- Andrea De Palma
- General, Emergency and Trauma Department, Pisa University Hospital
- Philip R. de Reuver
- Department of Surgery, Radboud University Medical Centre Nijmegen
- Carlos Domingo
- Department of General and Digestive Surgery, Hospital Universitario Doctor Peset
- Christian Cotsoglou
- General Surgery Department, ASST-Vimercat
- Alessandro Ferrero
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano “Umberto I”
- Gustavo P. Fraga
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp)
- Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma
- Federico Gheza
- Department of Clinical and Experimental Sciences, University of Brescia
- Angela Gurrado
- Unit of General Surgery “V. Bonomo”, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”
- Ewen Harrison
- Department of Clinical Surgery and Centre for Medical Informatics, Usher Institute, University of Edinburgh
- Angel Henriquez
- Centro Médico Laparoscópic
- Stefan Hofmeyr
- Division of Surgery, Surgical Gastroenterology Unit, Tygerberg Academic Hospital, University of Stellenbosch Faculty of Medicine and Health Sciences
- Roberta Iadarola
- Department of Emergency and Trauma Surgery of the University Hospital of Parma
- Jeffry L. Kashuk
- Department of Surgery, Tel Aviv University, Sackler School of Medicine
- Reza Kianmanesh
- Department of HBP and Digestive Oncologic Surgery, Robert Debré University Hospital
- Andrew W. Kirkpatrick
- Department of Surgery, Critical Care Medicine and the Regional Trauma Service, Foothills Medical Center
- Yoram Kluger
- Department of General Surgery, Rambam Healthcare Campus
- Filippo Landi
- Department of HPB and Transplant Surgery, Hospital Clínic, Universidad de Barcelona
- Serena Langella
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano “Umberto I”
- Real Lapointe
- Department of HBP Surgery and Liver Transplantation, Department of Surgery, Centre Hospitalier de l’Université de Montreal
- Bertrand Le Roy
- Department of Digestive Surgery, University Hospital of Saint-Etienne
- Alain Luciani
- Unit of Radiology, Henri Mondor University Hospital (AP-HP), Creteil, and Faculty of Medicine, University of Paris Est, UPEC
- Fernando Machado
- Department of Emergency Surgery, Hospital de Clínicas, School of Medicine UDELAR
- Umberto Maggi
- General Surgery and Liver Transplantation Unit, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico di Milano
- Ronald V. Maier
- Department of Surgery, University of Washington
- Alain Chichom Mefire
- Department of Surgery and Obstetrics/Gynecologic, Regional Hospital
- Kazuhiro Hiramatsu
- Department of General Surgery, Toyohashi Municipal Hospital
- Carlos Ordoñez
- Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Universidad del Valle Cali
- Franca Patrizi
- Unit of Gastroenterology and Endoscopy, Maggiore Hospital
- Manuel Planells
- Department of General and Digestive Surgery, Hospital Universitario Doctor Peset
- Andrew B. Peitzman
- Department of Surgery, UPMC, University of Pittsburg, School of Medicine
- Juan Pekolj
- General Surgery, Liver Transplant Unit, Hospital Italiano de Buenos Aires
- Fabiano Perdigao
- Liver Transplant Unit, APHP, Unité de Chirurgie Hépatobiliaire et Transplantation hépatique, Hôpital Pitié Salpêtrière
- Bruno M. Pereira
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp)
- Patrick Pessaux
- Hepatobiliary and Pancreatic Surgical Unit, Visceral and Digestive Surgery, IHU mix-surg, Institute for Minimally Invasive Image-Guided Surgery, University of Strasbourg
- Michele Pisano
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII
- Juan Carlos Puyana
- Trauma & Acute Care Surgery – Global Health, University of Pittsburgh
- Sandro Rizoli
- Trauma and Acute Care Service, St Michael’s Hospital
- Luca Portigliotti
- Chirurgia Epato-Gastro-Pancreatica, Azienda Ospedaliera-Universitaria Maggiore della Carità
- Raffaele Romito
- Chirurgia Epato-Gastro-Pancreatica, Azienda Ospedaliera-Universitaria Maggiore della Carità
- Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George
- Behnam Sanei
- Department of Surgery, Isfahan University of Medical Sciences
- Olivier Scatton
- Liver Transplant Unit, APHP, Unité de Chirurgie Hépatobiliaire et Transplantation hépatique, Hôpital Pitié Salpêtrière
- Mario Serradilla-Martin
- Instituto de Investigación Sanitaria Aragón, Department of Surgery, Hospital Universitario Miguel Servet
- Anne-Sophie Schneck
- Digestive Surgery Unit, Centre Hospitalier Universitaire de Guadeloupe
- Mohammed Lamine Sissoko
- Service de Chirurgie, Hôpital National Blaise Compaoré de Ouagadougou
- Iradj Sobhani
- Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, Creteil, and Faculty of Medicine, University of Paris Est, UPEC
- Richard P. ten Broek
- Department of Surgery, Radboud University Medical Centre Nijmegen
- Mario Testini
- Unit of General Surgery “V. Bonomo”, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”
- Roberto Valinas
- Department of Surgery “F”, Faculty of Medicine, Clinic Hospital “Dr. Manuel Quintela”
- Giorgos Veloudis
- Veterans Fund Army Hospital
- Giulio Cesare Vitali
- Division of Transplantation, Department of Surgery, Geneva University Hospitals
- Dieter Weber
- Department of Trauma Surgery, Royal Perth Hospital
- Luigi Zorcolo
- Department of Surgery, Colorectal Surgery Unit, University of Cagliari
- Felice Giuliante
- Hepatobiliary Surgery Unit, Foundation “Policlinico Universitario A. Gemelli”, IRCCS
- Paschalis Gavriilidis
- Division of Gastrointestinal and HBP Surgery, Imperial College HealthCare, NHS Trust, Hammersmith Hospital
- David Fuks
- Institut Mutualiste Montsouris
- Daniele Sommacale
- Unit of Digestive, Hepatobiliary and Pancreatic Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), and Faculty of Medicine, University of Paris Est, UPEC
- DOI
- https://doi.org/10.1186/s13017-021-00369-w
- Journal volume & issue
-
Vol. 16,
no. 1
pp. 1 – 27
Abstract
Abstract Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.
Keywords
- Laparoscopic cholecystectomy
- Biliary duct injury
- Magnetic resonance imaging
- Antibiotic therapy
- Computed tomography
- Guidelines
