Application of Three-dimensional Visualization Technology in Early Surgical Repair of Bile Duct Injury During Laparoscopic Cholecystectomy

Author:

Yang Zhiqi1,Liu Jing2,Wu Lang2,Ding Yang2,Ma Songbo2,Yan Wentao2,Lan Yong1,Sha Xiaochun1,Cheng Jianbin1,Ma Zhiming1,Li Minghao1

Affiliation:

1. Ningxia Medical University

2. Ningxia Hui Autonomous Region Peoples Hospital

Abstract

Abstract

Objective: This study aimed to explore the application value of three-dimensional (3D) visualization technology in the early surgical repair of bile duct injury during laparoscopic cholecystectomy (LC). Methods: A retrospective analysis was conducted on the clinical data of 15 patients who underwent early surgical repair of bile duct injury during LC with the assistance of 3D visualization technology at the Hepatobiliary Surgery Department of Ningxia Hui Autonomous Region People's Hospital from January 2019 to December 2022. Postoperative efficacy and long-term follow-up outcomes were summarized. Results: Before the repair surgery, 15 cases of bile duct injury during LC were evaluated using 3D visualization technology according to the Strasberg-Bismuth classification: 2 cases of type C, 4 of type E1, 3 of type E2, 3 of type E3, and 3 of type E4. Intraoperative findings were consistent with the 3D visualization reconstruction results, and all patients successfully underwent hepaticojejunostomy using Roux-en-Y anastomosis guided by the 3D visualization navigation. The time interval between LC and bile duct repair surgery ranged from 5 to 28 (14.2 ± 9.7) days. The surgical time was between 120 and 190 (156.40 ± 23.92) min, and estimated blood loss ranged from 80 to 250 (119.66 ± 47.60) mL. The length of hospital stay ranged from 12 to 25 days (median: 16 days). One patient experienced mild bile leakage after the operation, which healed with conservative treatment. All patients were followed up for 12–56 months (median: 34 months) without any loss to follow-up. During the follow-up period, no complications, such as anastomotic stricture or stone formation, were observed. Conclusion: The application of 3D visualization technology for preoperative evaluation and intraoperative navigation can accurately and effectively facilitate early surgical repair of bile duct injury during LC and has clinical value for promotion and application.

Publisher

Springer Science and Business Media LLC

Reference21 articles.

1. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy;de'Angelis N;World J Emerg Surg,2021

2. Linhares BL, Magalhães Ada G, Cardoso PM et al. Bile duct injury following cholecystectomy. Rev Col Bras Cir. 2011 Mar-Apr;38(2):95 – 9. English, Portuguese.

3. Iatrogenic bile duct injuries: etiology, diagnosis and management;Jabłońska B;World J Gastroenterol,2009

4. Bile leak after elective laparoscopic cholecystectomy: role of MR imaging;Mungai F;J Radiol Case Rep,2013

5. Accuracy of percutaneous transhepatic cholangiography in predicting the location and nature of major bile duct injuries;Fidelman N;J Vasc Interv Radiol,2011

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