Iatrogenic bile duct injury: impact and management challenges

Abstract

Antonio Pesce, Stefano Palmucci, Gaetano La Greca, Stefano Puleo Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Catania, Italy Abstract: Iatrogenic bile duct injuries (BDIs) after laparoscopic cholecystectomy, being one of the most common performed surgical procedures, remain a substantial problem in gastrointestinal surgery with a significant impact on patient’s quality of life. The primary aim of this review was to discuss the classification of BDIs, the proposed methods to prevent biliary lesions, the associated risk factors, and the management challenges depending on the timing of recognition of the injury, its extension, the patient’s clinical condition, and the availability of experienced hepatobiliary surgeons. Early recognition of BDI is of paramount importance and limiting the diagnosis delay is crucial for an optimal postoperative outcome. The therapeutic management depends on the type and gravity of the biliary lesion, and includes endoscopic, radiologic, and surgical approaches. Keywords: bile duct injury, laparoscopic cholecystectomy, biliary anatomy, early recognition, management challenge, endoscopic treatment, surgical repair

Keywords

• bile duct injury
• laparoscopic cholecystectomy
• biliary anatomy
• early recognition
• management challenge