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Group name EquipeAT
Item Type Journal Article
Title Long-term consequences of bile duct injury after cholecystectomy
Creator Barbier et al.
Author L. Barbier
Author R. Souche
Author K. Slim
Author P. Ah-Soune
Abstract Late complications arising after bile duct injury (BDI) include biliary strictures, hepatic atrophy, cholangitis and intra-hepatic lithiasis. Later, fibrosis or even secondary biliary cirrhosis and portal hypertension can develop, enhanced by prolonged biliary obstruction associated with recurrent cholangitis. Secondary biliary cirrhosis resulting in associated hepatic failure or digestive tract bleeding due to portal hypertension is a substantial risk factor for morbidity and mortality after bile duct repair. Parameters that determine the management of late complications of BDI include the type of biliary injury, associated vascular injury, hepatic atrophy, the presence of intra-hepatic strictures or lithiasis, repetitive infectious complications, the quality of underlying parenchyma (fibrosis, secondary biliary cirrhosis) and the presence of portal hypertension. Endoscopic drainage is indicated for patients with uncontrolled acute sepsis, patients at high operative risk, patients with cirrhosis who are not eligible for liver transplantation and patients who have previously undergone several attempts at repair. Roux-en-Y hepaticojejunostomy, whether de novo or as an iterative repair, is the technique of reference for post-cholecystectomy BDI. Hepatic resection is indicated in only rare instances, mainly in case of extended hilar stricture, multiple stone retention in one sector of the liver or in patients for whom the repair is deemed technically difficult. Liver transplantation is indicated only in exceptional circumstances, when secondary biliary cirrhosis is associated with liver failure and portal hypertension.
Publication Journal of Visceral Surgery
Volume 151
Issue 4
Pages 269-279
Date Sep 2014
Journal Abbr J Visc Surg
Language eng
DOI 10.1016/j.jviscsurg.2014.05.006
ISSN 1878-7886
Library Catalog PubMed
Extra PMID: 24954866
Tags Bile duct injury, Bile Ducts, Cholangitis, Cholecystectomy, Cholecystectomy, Laparoscopic, Cholestasis, clinic, Female, Follow-Up Studies, France, Humans, Intraoperative Complications, Liver Cirrhosis, Biliary, Male, Postoperative Complications, Quality of Life, Reoperation, Risk Assessment, Secondary biliary cirrhosis, Time Factors
Date Added 2019/05/29 - 14:24:06
Date Modified 2019/05/29 - 15:21:27
Notes and Attachments PubMed entry (Attachment)


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