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Updated: Aug 19, 2026
Laparoscopic Left Lateral Sectionectomy: Guided by the Ligamentum Teres Hepatis and the Umbilical Fissure Vein
Published on: September 27, 2024
[Biliary lesions after laparoscopic cholecystectomy]
M A Gioffrè Florio1, G Giacobbe, A Cogliandolo
1Dipartimento di Patologia Umana, Chirurgia Generale V, Università degli Studi di Messina.
Insights
Laparoscopic cholecystectomy is effective for gallstones, with a low complication rate of 0.6% for bile duct lesions. Early diagnosis and multidisciplinary treatment ensure optimal outcomes for patients.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Hepatobiliary Surgery
Context:
- Symptomatic cholelithiasis management.
- Laparoscopic cholecystectomy (LC) is the standard treatment.
- Potential for higher biliary lesion rates compared to open surgery.
Purpose:
- To report the incidence, causes, diagnosis, and treatment of complications from LC.
- To analyze outcomes in a homogeneous group of LC procedures.
Summary:
- A study of 492 LC procedures found 3 bile duct lesions (0.6%).
- Lesions included two biliary leakages and one bile duct stricture.
- Endoscopic treatment resolved biliary leaks; surgery was needed for stricture.
Impact:
- Highlights the safety and efficacy of LC for symptomatic cholelithiasis.
- Emphasizes the importance of understanding complication aetiopathogenesis.
- Advocates for a multidisciplinary approach for optimal diagnosis and treatment of LC complications.
Abstract:
Laparoscopic cholecystectomy is the suitable treatment for symptomatic cholelithiasis, even if the incidence of biliary lesions following this procedure may be up to threefold higher than that of open cholecystectomy. We report our experience concerning the incidence, aetiopathogenesis, diagnosis and treatment of complications in a homogeneous group of laparoscopic cholecystectomies. In a total of 492 laparoscopic cholecystectomies only three bile duct lesions were observed (0.6%); they were classified according to Bismuth and re-assessed according to Strasberg. They consisted in two biliary leakages and one bile duct stricture. All patients were evaluated by full blood test, ultrasonography and endoscopic retrograde cholangiopancreatography. Endoscopic treatment was successful in the two patients with biliary leakage, while the patient with a stricture required surgical therapy. In conclusion, we suggest that a correct knowledge of the aetiopathogenesis together with a multidisciplinary approach to the diagnosis appear to be the best method for the detection, complete classification and most suitable treatment of symptomatic cholelithiasis.
