Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management
Abstract Background Iatrogenic bile duct injuries are unusual but possibly associated with fatal complications with increased incidence since the introduction of laparoscopic cholecystectomy. Appropriate estimation of these injuries is essential for proper management. Imaging is vital for the initia...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-01-01
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| Series: | Egyptian Liver Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43066-023-00238-y |
| _version_ | 1797946002316984320 |
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| author | Mohamed Saied Abdelgawad Mohamed Eid Sameh Abokoura Mohamed Amin Elmazaly Rasha Abdelhafiz Aly |
| author_facet | Mohamed Saied Abdelgawad Mohamed Eid Sameh Abokoura Mohamed Amin Elmazaly Rasha Abdelhafiz Aly |
| author_sort | Mohamed Saied Abdelgawad |
| collection | DOAJ |
| description | Abstract Background Iatrogenic bile duct injuries are unusual but possibly associated with fatal complications with increased incidence since the introduction of laparoscopic cholecystectomy. Appropriate estimation of these injuries is essential for proper management. Imaging is vital for the initial diagnosis, extent assessment and consequently, treatment guidance of bile duct injury with an ideal outcome. In this study, MRCP was carried out in 37 cases (28 females and 9 males, age range from 19 to 58 years) with suspected BDI following laparoscopic cholecystectomy. MRCP images were assessed for bile duct transection injury, strictures, biliary leakage, and intrahepatic biliary radicles (IHBR) dilatation. In positive cases, Strasberg classification system was used with the definitive diagnosis was done regarding the surgical findings and/or findings on endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). Results Our study includes 37 cases with biliary injuries. On MRCP our cases were stratified regarding the Strasberg-Bismuth classification into five types (A to E). Most BDIs were type E2 (29.7%), followed by type E1 (18.9%), type A (16.2%), type E3 (10.8%), type E4 (8.2%), type C (5.4%), and type D and finally type E5 and B injuries with each one representing 2.7%. Twenty cases presented with biliary leakage and seventeen with bile duct obstruction, whether duct ligation or stricture. Conclusion MRCP is an essential imaging modality for assessment of iatrogenic BDIs enabling the radiologists to classify these injuries and helps to govern the management. |
| first_indexed | 2024-04-10T21:05:04Z |
| format | Article |
| id | doaj.art-23de123ec2c74efcad5cb7ee6427474e |
| institution | Directory Open Access Journal |
| issn | 2090-6226 |
| language | English |
| last_indexed | 2024-04-10T21:05:04Z |
| publishDate | 2023-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Liver Journal |
| spelling | doaj.art-23de123ec2c74efcad5cb7ee6427474e2023-01-22T12:05:13ZengSpringerOpenEgyptian Liver Journal2090-62262023-01-0113111010.1186/s43066-023-00238-yIatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before managementMohamed Saied Abdelgawad0Mohamed Eid1Sameh Abokoura2Mohamed Amin Elmazaly3Rasha Abdelhafiz Aly4Radiology Department, National liver institute, Menoufia UniversityRadiology Department, Faculty of Medicine, Alexandria UniversityRadiology Department, National liver institute, Menoufia UniversityHepatology and Gastroenterology Department, National Liver Institute, Menoufia UniversityRadiology Department, National liver institute, Menoufia UniversityAbstract Background Iatrogenic bile duct injuries are unusual but possibly associated with fatal complications with increased incidence since the introduction of laparoscopic cholecystectomy. Appropriate estimation of these injuries is essential for proper management. Imaging is vital for the initial diagnosis, extent assessment and consequently, treatment guidance of bile duct injury with an ideal outcome. In this study, MRCP was carried out in 37 cases (28 females and 9 males, age range from 19 to 58 years) with suspected BDI following laparoscopic cholecystectomy. MRCP images were assessed for bile duct transection injury, strictures, biliary leakage, and intrahepatic biliary radicles (IHBR) dilatation. In positive cases, Strasberg classification system was used with the definitive diagnosis was done regarding the surgical findings and/or findings on endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). Results Our study includes 37 cases with biliary injuries. On MRCP our cases were stratified regarding the Strasberg-Bismuth classification into five types (A to E). Most BDIs were type E2 (29.7%), followed by type E1 (18.9%), type A (16.2%), type E3 (10.8%), type E4 (8.2%), type C (5.4%), and type D and finally type E5 and B injuries with each one representing 2.7%. Twenty cases presented with biliary leakage and seventeen with bile duct obstruction, whether duct ligation or stricture. Conclusion MRCP is an essential imaging modality for assessment of iatrogenic BDIs enabling the radiologists to classify these injuries and helps to govern the management.https://doi.org/10.1186/s43066-023-00238-yLaparoscopic cholecystectomyBile duct injuries (BDIs)Intrahepatic biliary radicles (IHBR)Magnetic resonance cholangiopancreatography (MRCP) |
| spellingShingle | Mohamed Saied Abdelgawad Mohamed Eid Sameh Abokoura Mohamed Amin Elmazaly Rasha Abdelhafiz Aly Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management Egyptian Liver Journal Laparoscopic cholecystectomy Bile duct injuries (BDIs) Intrahepatic biliary radicles (IHBR) Magnetic resonance cholangiopancreatography (MRCP) |
| title | Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management |
| title_full | Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management |
| title_fullStr | Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management |
| title_full_unstemmed | Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management |
| title_short | Iatrogenic bile duct injuries after laparoscopic cholecystectomy: evaluation by MRCP before management |
| title_sort | iatrogenic bile duct injuries after laparoscopic cholecystectomy evaluation by mrcp before management |
| topic | Laparoscopic cholecystectomy Bile duct injuries (BDIs) Intrahepatic biliary radicles (IHBR) Magnetic resonance cholangiopancreatography (MRCP) |
| url | https://doi.org/10.1186/s43066-023-00238-y |
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