Poranění žlučových cest při cholecystektomii

English version

Autoři: V. K. Kapoor
Působiště autorů: Sanjay Gandhi Post-graduate Institute of Medical Sciences (SGPGIMS), Lucknow India
Vyšlo v časopise: Rozhl. Chir., 2015, roč. 94, č. 8, s. 312-315.
Kategorie: Souhrnné sdělení

Souhrn

Laparoscopic cholecystectomy (LC) is the treatment of choice for gall stones but is associated with an increased risk of bile duct injury (BDI). A BDI detected during LC may be repaired if a biliary surgeon is available but the easiest and safest option for a general surgeon is to place drains in the subhepatic fossa to covert the acute BDI into a controlled external biliary fistula (EBF). Most BDIs are diagnosed in the postoperative period and result in bile leak. Treatment is with percutaneous catheter drainage and endoscopic stenting of the bile duct; early repair is not recommended. Repair, in the form of hepatico-jejunostomy (HJ), should be performed by a biliary surgeon after a delay of 4−6 weeks when the EBF has closed. BDI is a common cause of medico-legal suit and a large burden on healthcare costs. Most BDIs can be prevented by adhering to the principles of safe cholecystectomy.

Key words:
bile duct injury − bile leak − biliary fistula − biliary stricture – cholecystectomy − hepatico-jejunostomy

Zdroje

1. Acalovschi M. Epidemiology of gallstone disease. In: M Acalovschi, G Paumgartner, eds. Hepatobiliary Diseases: Cholestasis and Gallstones – Falk Workshop. London, Kluwer Academic Publishers 200:117–30.

2. Aerts R, Penninckz F. The burden of gallstone disease in Europe. Aliment Pharmacol Ther 2003;18 (Suppl.3):49–53.

3. Alkhaffaf B, Decadt B. 15 years of litigation following laparoscopic cholecystectomy in England. Ann Surg 2010; 251:682−5.

4. Archer SB, Brown DW, Smith CD, et al. Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Ann Surg 2001;234:549−58; discussion 558−9.

5. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg 200;25:1241−4.

6. Dageforde LA, Landman MP, Feurer ID, et al. A cost-effectiveness analysis of early vs late reconstruction of iatrogenic bile duct injuries. J Am Coll Surg 2012;214:919−27.

7. de Reuver PR, Busch OR, Rauws EA, et al. Long-term results of a primary end-to-end anastomosis in peroperative detected bile duct injury. J Gastrointest Surg 2007;11:296−302.

8. Devière J, Nageshwar Reddy D, et al. Benign Biliary Stenoses Working Group. Successful management of benign biliary strictures with fully covered self-expanding metal stents. Gastroenterology 2014;147:385−95.

9. Gossage JA, Forshaw MJ. Prevalence and outcome of litigation claims in England after laparoscopic cholecystectomy. Int J Clin Pract. 2010;64:1832−5.

10. Landman MP, Feurer ID, Moore DE, et al. The long-term effect of bile duct injuries on health-related quality of life: a meta-analysis. HPB (Oxford) 2013;15:252−9.

11. Laurent A, Sauvanet A, Farges O, et al. Major hepatectomy for the treatment of complex bile duct injury. Ann Surg 2008;248:77−83.

12. Mercado MA, Chan C, Jacinto JC, et al. Voluntary and involuntary ligature of the bile duct in iatrogenic injuries: a nonadvisable approach. J Gastrointest Surg 2008;12:1029−32.

13. Parrilla P, Robles R, Varo E, et al. Spanish liver transplantation study group. Liver transplantation for bile duct injury after open and laparoscopic cholecystectomy. Br J Surg 2014;101:63−8.

14. Perera MT, Silva MA, Shah AJ, et al. Risk factors for litigation following major transectional bile duct injury sustained at laparoscopic cholecystectomy. World J Surg 2010;34:2635−41.

15. Sicklick JK, Camp MS, Lillemoe KD, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg 2005;241:786−92; discussion 793−5.

16. Silva MA, Coldham C, Mayer AD, et al. Specialist outreach service for on-table repair of iatrogenic bile duct injuries − a new kind of ‘travelling surgeon’. Ann R Coll Surg Engl 2008;90:243−6.

17. Sinha S, Hofman D, Stoker DL, et al. Epidemiological study of provision of cholecystectomy in England from 2000 to 2009: retrospective analysis of Hospital Episode Statistics. Surg Endosc 2013;27:162−75.

18. Stewart L, Robinson TN, Lee CM, et al. Right hepatic artery injury associated with laparoscopic bile duct injury: incidence, mechanism, and consequences. J Gastrointest Surg 2004;8:523−30; discussion 530−1.

19. Stilling NM, Fristrup C, Wettergren A, et al. Long-term outcome after early repair of iatrogenic bile duct injury. A national Danish multicentre study. HPB (Oxford). 2015 Jan 12. [Epub ahead of print]

20. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 1995;180:101−25.

21. Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg 2010;211:132−8.

22. Törnqvist B, Strömberg C, Persson G, et al. Effect of intended intraoperative cholangiography and early detection of bile duct injury on survival after cholecystectomy: population based cohort study. BMJ 2012;345:e6457.

23. Tuvignon N, Liguory C, Ponchon T, et al. Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study. Endoscopy 2011;43:208−16.

24. Waage A, Nilsson M. Iatrogenic bile duct injury: a population based study of 152776 cholecystectomies in the Swedish inpatient registry. Arch Surgery 2006; 141:1207−13.

25. Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 2003;237:460−9.

26. Xu XD, Zhang YC, Gao P, et al. Treatment of major laparoscopic bile duct injury: a long-term follow-up result. Am Surg 2011;77:1584−8.

Suggested Readings

1. Kapoor VK. Bile duct injury repair – When? What? Who? Journal of HBP Surgery 2007;14:476−9.

2. Kapoor VK. Management of bile duct injuries: a practical approach. American Surgeon 2009;75:1157−60.

3. Kapoor VK. Safe Cholecystectomy – A to Z (Foreword by John G Hunter). Lucknow: Shubham 2010: 1-128. ISBN 978-81-910315-0-8. Available for free download at http://vkkapoor-india.weebly.com/uploads/1/4/6/7/1467272/safe_chole_a_to_z.pdf.pdf