Acta clinica Croatica, Vol. 56. No. 1., 2017.
Ostalo
https://doi.org/10.20471/acc.2017.56.01.25
Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report
Ivan Zoričić
; School of Medicine, Josip Juraj Strossmayer University, Osijek
Ivo Soldo
; Department of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Ivan Simović
; Department of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Marko Sever
; Department of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Branko Bakula
orcid.org/0000-0001-6981-7877
; Department of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Martin Grbavac
; Department of Hepatobiliary Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Marinko Marušić
orcid.org/0000-0002-1552-1832
; Clinical Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sveti Duh University Hospital, Zagreb, Croatia
Anamaria Soldo
; Clinical Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sveti Duh University Hospital, Zagreb, Croatia
Sažetak
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.
Ključne riječi
holecystectomy, laparoscopic; Bile ducts – injury; Cholangiography; Jaundice; Case reports
Hrčak ID:
184765
URI
Datum izdavanja:
1.3.2017.
Posjeta: 3.293 *