Bile leak from the accessory biliary duct following laparascopic cholecystectomy

Pisanu, Adolfo and Altana, Maria Luisa and Piu, Sara and Uccheddu, Alessandro (2003) Bile leak from the accessory biliary duct following laparascopic cholecystectomy. Il giornale di chirurgia, 24 (4). pp. 115-118. ISSN 1971-145x

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Abstract

tomists and surgeons have described the presence of accessory biliary ducts between the liver and gallbladder. Bile leakage from accessory duct following laparoscopic cholecystectomy (LC) is an unu - sual post-operative complication. Aim of the study was to assess its incidence, the intraoperative methods helpful for notice the anatomical anomaly and the impact of endoscopic procedure as a suitable treatment. From January 1997 to September 2002, 185 patients underwent LC for symptomatic cholelithiasis in our surgical department. Post-ope - rative bile leakage from accessory biliary duct occurred in two patients (1%): one case from the liver bed of gallbladder (duct of Luschka) and one case from an aberrant cholecystohepatic duct entering Hartmann’s pouch. One patient underwent open celiotomy because of unavailabi - lity of endoscopic retrograde cholangiopancreatography. The other patient was successfully treated by endoscopic sphincterotomy and naso - biliary tube placement. By careful dissection, accessory ducts were noti - ced and clipped in three other patients with overall incidence of 2.7%. Meticulous laparoscopic technique aimed to careful recognize all structures during LC is the main policy to contain biliary injury within its nadir incidence. Depending of availability, endoscopic sphincterotomy and nasobiliary drainage allow diagnosis and treat - ment of bile leakage, preserving the effectiveness of laparoscopic proc e - d u r e .

Item Type:	Article
Uncontrolled Keywords:	Laparoscopia, Colecistectomia, Dotto biliare accessorio, Filtrazione biliare
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Chiara D'Arpa
Date Deposited:	22 Oct 2013 15:41
Last Modified:	22 Oct 2013 15:41
URI:	http://eprints.bice.rm.cnr.it/id/eprint/6511

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