Dataset Information

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

ABSTRACT: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

SUBMITTER: de'Angelis N

PROVIDER: S-EPMC8190978 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

de'Angelis Nicola N Catena Fausto F Memeo Riccardo R Coccolini Federico F Martínez-Pérez Aleix A Romeo Oreste M OM De Simone Belinda B Di Saverio Salomone S Brustia Raffaele R Rhaiem Rami R Piardi Tullio T Conticchio Maria M Marchegiani Francesco F Beghdadi Nassiba N Abu-Zidan Fikri M FM Alikhanov Ruslan R Allard Marc-Antoine MA Allievi Niccolò N Amaddeo Giuliana G Ansaloni Luca L Andersson Roland R Andolfi Enrico E Azfar Mohammad M Bala Miklosh M Benkabbou Amine A Ben-Ishay Offir O Bianchi Giorgio G Biffl Walter L WL Brunetti Francesco F Carra Maria Clotilde MC Casanova Daniel D Celentano Valerio V Ceresoli Marco M Chiara Osvaldo O Cimbanassi Stefania S Bini Roberto R Coimbra Raul R Luigi de'Angelis Gian G Decembrino Francesco F De Palma Andrea A de Reuver Philip R PR Domingo Carlos C Cotsoglou Christian C Ferrero Alessandro A Fraga Gustavo P GP Gaiani Federica F Gheza Federico F Gurrado Angela A Harrison Ewen E Henriquez Angel A Hofmeyr Stefan S Iadarola Roberta R Kashuk Jeffry L JL Kianmanesh Reza R Kirkpatrick Andrew W AW Kluger Yoram Y Landi Filippo F Langella Serena S Lapointe Real R Le Roy Bertrand B Luciani Alain A Machado Fernando F Maggi Umberto U Maier Ronald V RV Mefire Alain Chichom AC Hiramatsu Kazuhiro K Ordoñez Carlos C Patrizi Franca F Planells Manuel M Peitzman Andrew B AB Pekolj Juan J Perdigao Fabiano F Pereira Bruno M BM Pessaux Patrick P Pisano Michele M Puyana Juan Carlos JC Rizoli Sandro S Portigliotti Luca L Romito Raffaele R Sakakushev Boris B Sanei Behnam B Scatton Olivier O Serradilla-Martin Mario M Schneck Anne-Sophie AS Sissoko Mohammed Lamine ML Sobhani Iradj I Ten Broek Richard P RP Testini Mario M Valinas Roberto R Veloudis Giorgos G Vitali Giulio Cesare GC Weber Dieter D Zorcolo Luigi L Giuliante Felice F Gavriilidis Paschalis P Fuks David D Sommacale Daniele D

World journal of emergency surgery : WJES 20210610 1

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some ...[more]

PMID: 34112197

Similar Datasets

Project description:BackgroundBile duct injury (BDI) is still a major worrisome complication that is feared by all surgeons undergoing cholecystectomy. The overall incidence of biliary duct injuries falls between 0.2 and 1.3%. BDI classification remains an important method to define the type of injury conducted for investigation and management. Recently, a Consensus has been taken to define BDI using the ATOM classification. Early management brings better results than delayed management. The current perspective in biliary surgery is the laparoscopic role in diagnosing and managing BDI. Diagnostic laparoscopy has been conducted in various entities for diagnostic and therapeutic measures in minor and major BDIs.Methods35 cases with iatrogenic BDI following cholecystectomy (after both open and laparoscopic approaches) both happened in or were referred to Alexandria Main University Hospital surgical department from January 2019 till May 2022 and were analyzed retrospectively. Patients were classified according to the ATOM classification. Management options undertaken were mentioned and compared to the timing of diagnosis, and the morbidity and mortality rates (using the Clavien-Dindo classification).Results35 patients with BDI after both laparoscopic cholecystectomy (LC) (54.3%), and Open cholecystectomy (OC) (45.7%) (20% were converted and 25.7% were Open from the start) were classified according to ATOM classification. 45.7% were main bile duct injuries (MBDI), and 54.3% were non-main bile duct injuries (NMBDI), where only one case 2.9% was associated with vasculobiliary injury (VBI). 28% (n = 10) of the cases were diagnosed intraoperatively (Ei), 62.9% were diagnosed early postoperatively (Ep), and 8.6% were diagnosed in the late postoperative period (L). LC was associated with 84.2% of the NMBDI, and only 18.8% of the MBDI, compared to OC which was associated with 81.3% of the MBDI, and 15.8% of the NMBDI. By the Clavien-Dindo classification, 68.6% fell into Class IIIb, 20% into Class I, 5.7% into Class V (mortality rate), 2.9% into Class IIIa, and 2.9% into Class IV. The Clavien-Dindo classification and the patient's injury (type and time of detection) were compared to investigation and management options.ConclusionManagement options should be defined individually according to the mode of presentation, the timing of detection of injury, and the type of injury. Early detection and management are associated with lower morbidity and mortality. Diagnostic Laparoscopy was associated with lower morbidity and better outcomes. A proper Reporting checklist should be designed to help improve the identification of injury types.

Dataset Information

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Publications

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets