Sb. Doldi et al., Iatrogenic injury in videolaparoscopic cholecystectomy: Difficult surgicalcorrection biliary tract, HEP-GASTRO, 46(27), 1999, pp. 1631-1633
Two cases of biliary tract serious lesions during videolaparoscopic cholecy
stectomy are reported. In the first case of lithiasic cholecystitis there h
ad been a complete damage of the common biliary duct; in the second case th
ere had been a double main biliary duct binding with removal of a biliary t
ract segment. In both cases a biliary confluence;jejunal anastomosis with R
oux-en-Y loop was made up. In the first one the operation was difficult bec
ause of the main bile duct's fragility and modest expansion. In the second
one the presence of a secondary biliary duct in gallbladder fossa not recog
nized, but drained outside with a common drainage placed during the operati
on prevented appearance of jaundice with dilatation of biliary ducts. It wa
s heavily conditioned performing confluence-jejunal anastomosis with Roux-e
n-Y loop.
The post-operative course was characterized by appearance of an external bi
liary fistula which has spontaneously disappeared. One year later, neither
of the two patients had any stenosis or cholangitis problems.