Case Report

Bile Duct Injury during Laparoscopic Cholecystectomy in a Polycystic Liver

Paolo Orsaria, Giuseppe Petrella, Oreste Buonomo, Maria Caputo, Giovanni Salvini and Marco Conte
World Journal of Medical and Surgical Case Reports 2013, 2:18

Abstract

Introduction

Cystic lesions of the liver consist of a heterogeneous group of disorders and might present a diagnostic and therapeutic challenge. Large hepatic cysts are symptomatic and cause complications more often than smaller cysts. In addition, the anatomical localization might present an additional risk factor in the incidence of bile duct injury (BDI) during laparoscopic cholecystectomy (LC).

Study design

Currently, there are no randomized trials concerning the increased incidence of BDI in patients with multicystic livers. To assess the specific diagnostic and management problems of this case the clinical benefits of early diagnosis, adequate surgical technique, and multidisciplinary management are discussed.

Material and methods

We described a case of bile duct injury following LC in a patient with a preoperative diagnosis of multicystic liver and cholelithiasis, analyzing the disease treatment profile through findings on physical examination, laboratory, radiological and pathological investigations.

Results

The intraoperative detection of bile leakage facilitated the immediate repair of the biliary tree with a good surgical and clinical outcome at 18 months follow-up.

Conclusions

The manifestation of bile duct injuries during the postoperative period might be reduced through early detection and timely management. Improved results can be achieved through the judicious selection of a combination of interventions in the majority of patients. These diagnostic and therapeutic topics might offer a new classification system with economic and functional value to improve the performance and surgical outcome of the patient.

Key Words

multicystic liver, bile duct injury, BDI, cholelithiasis, laparoscopic cholecystectomy

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