Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report

Despite progress in laparoscopic surgery and increasing surgical experience, the incidence of bile duct injury during laparoscopic cholecystectomy fails to fall below 0.3%-0.6% and it is still higher than those recorded in the era of open cholecystectomy. Bile duct injuries belong to the most seriou...

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Main Authors: Ivan Zoričić, Ivo Soldo, Branko Bakula, Ivan Simović, Marko Sever, Martin Grbavac, Marinko Marušić, Anamaria Soldo
Format: Article
Language:English
Published: Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2017-01-01
Series:Acta Clinica Croatica
Subjects:
Online Access:http://hrcak.srce.hr/file/272408
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spelling doaj-e1ddbf07730b47b3aa8febb343357c5b2020-11-24T23:39:32ZengSestre Milosrdnice University hospital, Institute of Clinical Medical Research Acta Clinica Croatica0353-94661333-94512017-01-0156.1.179182Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case ReportIvan Zoričić0Ivo Soldo1Branko Bakula2Ivan Simović3Marko Sever4Martin Grbavac5Marinko Marušić6Anamaria Soldo7School of Medicine, Josip Juraj Strossmayer University, OsijekDepartment of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, CroatiaDepartment of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, CroatiaDepartment of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, CroatiaDepartment of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, CroatiaDepartment of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, CroatiaClinical Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sveti Duh University Hospital, Zagreb, CroatiaClinical Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sveti Duh University Hospital, Zagreb, CroatiaDespite progress in laparoscopic surgery and increasing surgical experience, the incidence of bile duct injury during laparoscopic cholecystectomy fails to fall below 0.3%-0.6% and it is still higher than those recorded in the era of open cholecystectomy. Bile duct injuries belong to the most serious complications of abdominal surgery in general and often end up with liver transplantation as the only hope for cure. We present a case of a 78-year-old jaundiced male patient who sustained common hepatic duct injury during laparoscopic cholecystectomy eight months earlier. Exploratory laparotomy, ERCP and MRCP revealed a metal clip placed just below hepatic duct confluence and causing stricture of bile duct with dilatation of bile ducts proximal to the level of stenosis (Strasberg classification type E3 injury). Repair of the injury was performed by creating termino-lateral hepaticojejunostomy between the right and left hepatic ducts and retrocolic Roux en-Y jejunal limb. By presenting this case, we wish to emphasize the importance of timely conversion and execution of intraoperative cholangiography in all cases when identification of the structures of Calot’s triangle is not clear enough. Successful treatment of bile duct injury is only possible with joint approach of radiologist, gastroenterologist and experienced hepatobiliary surgeon.http://hrcak.srce.hr/file/272408holecystectomy, laparoscopicBile ducts – injuryCholangiographyJaundiceCase reports
collection DOAJ
language English
format Article
sources DOAJ
author Ivan Zoričić
Ivo Soldo
Branko Bakula
Ivan Simović
Marko Sever
Martin Grbavac
Marinko Marušić
Anamaria Soldo
spellingShingle Ivan Zoričić
Ivo Soldo
Branko Bakula
Ivan Simović
Marko Sever
Martin Grbavac
Marinko Marušić
Anamaria Soldo
Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
Acta Clinica Croatica
holecystectomy, laparoscopic
Bile ducts – injury
Cholangiography
Jaundice
Case reports
author_facet Ivan Zoričić
Ivo Soldo
Branko Bakula
Ivan Simović
Marko Sever
Martin Grbavac
Marinko Marušić
Anamaria Soldo
author_sort Ivan Zoričić
title Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
title_short Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
title_full Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
title_fullStr Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
title_full_unstemmed Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
title_sort common bile duct stricture after laparoscopic cholecystectomy: case report
publisher Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
series Acta Clinica Croatica
issn 0353-9466
1333-9451
publishDate 2017-01-01
description Despite progress in laparoscopic surgery and increasing surgical experience, the incidence of bile duct injury during laparoscopic cholecystectomy fails to fall below 0.3%-0.6% and it is still higher than those recorded in the era of open cholecystectomy. Bile duct injuries belong to the most serious complications of abdominal surgery in general and often end up with liver transplantation as the only hope for cure. We present a case of a 78-year-old jaundiced male patient who sustained common hepatic duct injury during laparoscopic cholecystectomy eight months earlier. Exploratory laparotomy, ERCP and MRCP revealed a metal clip placed just below hepatic duct confluence and causing stricture of bile duct with dilatation of bile ducts proximal to the level of stenosis (Strasberg classification type E3 injury). Repair of the injury was performed by creating termino-lateral hepaticojejunostomy between the right and left hepatic ducts and retrocolic Roux en-Y jejunal limb. By presenting this case, we wish to emphasize the importance of timely conversion and execution of intraoperative cholangiography in all cases when identification of the structures of Calot’s triangle is not clear enough. Successful treatment of bile duct injury is only possible with joint approach of radiologist, gastroenterologist and experienced hepatobiliary surgeon.
topic holecystectomy, laparoscopic
Bile ducts – injury
Cholangiography
Jaundice
Case reports
url http://hrcak.srce.hr/file/272408
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