Operative strategy can reduce the incidence of
major bile duct injury in laparoscopic cholecystectomy.
Type Specification A Leakage from cystic duct or peripheral radicals B
Major bile duct injury with leakage C Bile duct stricture without leakage D Complete transection or excision of common bile duct
(1) The major disadvantage of LC, however, is the biliary complications associated with the procedure, the most serious of which is a
major bile duct injury (BDI).
The implications of a
major bile duct injury can be profound, with the spectre of protracted hospitalisation and invasive investigations, the anxiety of major reconstructive surgery, a lengthy rehabilitation period, decreased quality of life, loss of income and, in some cases (particularly in the present SA medicolegal environment--see above), prolonged and unpleasant litigation.
Major bile duct injury is most serious and most common reported complication.
A total number of 25 patients were included in the study who presented with a transection or laceration of the common hepatic or the common bile duct also classified as a
major bile duct injury which was recog-nized on magnetic resonance cholangiopancreaticogra-phy.
[5] Optimal evaluation of a
major bile duct injury requires careful, co-ordinated, multidisciplinary assessment by a knowledgeable group of surgeons, intensivists, endoscopists and interventional radiologists.
In 16 (14.2%) ERCP demonstrated a
major bile duct injury without ductal continuity, which required surgical repair by hepaticojejunostomy.
