The chain of postoperative complications after laparoscopic cholecystectomy
Mehmet Karabulut, Murat Gönenç, Halil Alış
Clinic of General Surgery, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
Abstract
Bile duct injuries are among the most dreadful complications of cholecystectomy. As laparoscopic cholecystectomy has become increasingly popular, the incidence of this complication increased and has remained unchanged in spite the learning curve being completed. A 50-year-old female underwent elective laparoscopic cholecystectomy for gallstone disease. A complicated bile duct injury occurred during the procedure. As the injury was immediately recognized, it was treated with concomitant hepaticojejunostomy. In the postoperative period, biliary fistula, which was assumed to be the result of an anastomotic leak, was encountered. Diagnostic and therapeutic percutaneous transhepatic biliary drainage was considered. It revealed that the anastomosis was intact and the source of biliary leak was an aberrant right posterior sectorial branch. A severe bleeding through the biliary catheter occurred due to transmigration of the catheter into the portal vein. Bleeding was controlled with embolization by the interventional radiologist. The patient thereafter was re-operated, and the leakage was sealed by ligation of the aberrant right posterior sectorial branch. The postoperative period was uneventful. As long as cholecystectomy is performed, bile duct injuries will always exist. Therefore, every abdominal surgeon should be aware of possible consequences of complications related to this procedure.
Keywords: Cholecystectomy, bile duct injury, hepaticojejunostomy, percutaneous biliary drainage
Ethics committee approval was received for this study from the ethics committee of Bakırköy Dr. Sadi Konuk Training and Research Hospital.
Written informed consent was obtained from patient who participated in this case.
Externally peer-reviewed.
Concept - M.K.; Design - M.K.; Supervision - M.G., H.A.; Data Collection and/or Processing - M.K.; Analysis and/or Interpretation - H.A., M.G.; Literature Review - M.K.; Writer - M.G.; Critical Review - H.A.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.