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World J Gastrointest Surg. Apr 27, 2023; 15(4): 592-599
Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.592
Initial management of suspected biliary injury after laparoscopic cholecystectomy
Antti Siiki, Reea Ahola, Yrjö Vaalavuo, Anne Antila, Johanna Laukkarinen
Antti Siiki, Reea Ahola, Yrjö Vaalavuo, Anne Antila, Johanna Laukkarinen, Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere 33521, Finland
Johanna Laukkarinen, Faculty of Medicine and Health Technology, University of Tampere, Tampere 33521, Finland
Author contributions: Siiki A, Ahola R, Vaalavuo Y, Antila A and Laukkarinen J contributed to the manuscript drafting and revision.
Conflict-of-interest statement: The authors declare no relevant conflict of interest. Authors Siiki and Laukkarinen have received lecture fees from Boston Scientific, Cook Medical and Olympus Europe.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Antti Siiki, MD, PhD, Surgeon, Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, Tampere 33521, Finland. antti.siiki@fimnet.fi
Received: December 28, 2022
Peer-review started: December 28, 2022
First decision: January 12, 2023
Revised: January 26, 2023
Accepted: March 15, 2023
Article in press: March 15, 2023
Published online: April 27, 2023
Core Tip

Core Tip: A rare, but potentially disastrous bile duct injury (BDI) after laparoscopic cholecystectomy may easily go unnoticed at first. Thus, any unwell patient or anyone not recovering properly in the first post-operative days after surgery should be considered as having a surgical complication unless proven otherwise. The right initial management in suspected BDI is essential for prognosis. Early referral to a hepato-biliary unit, combination of modern imaging modalities and consequent evaluation of the severity grade of the injury are the foundations of management. The initial treatment options range from percutaneous and endoscopic methods to surgery, the timing and details of which need a multi-disciplinary hepato-biliary approach.