Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy(249 views) Ragozzino A, Lassandro F, De Ritis R, Imbriaco M
Keywords: Hepatectomy, Laparoscopic Cholecystectomy, Gadolinium Pentetate Meglumine, Adult, Artery Injury, Artery Occlusion, Article, Bile Duct Dilatation, Bile Duct Injury, Bile Duct Obstruction, Case Report, Conservative Treatment, Excision, Female, Hepatic Artery, Hepatojejunostomy, Human, Intensive Care, Liver Resection, Magnetic Resonance Angiography, Magnetic Resonance Cholangiopancreatography, Postoperative Complication, Priority Journal, Treatment Planning, Vein Injury, Contrast Media, Fatal Outcome, Magnetic Resonance Imaging, Portal Vein,
Affiliations: *** IBB - CNR ***
Departments of Radiology, Cardarelli Hospital, University Federico II, Via Pansini 5, Napoli, Italy
References: Archer, S.B., Brown, D.W., Smith, C.D., Branum, G.D., Hunter, J.G., Bile duct injury during laparoscopic cholecystectomy. Results of a national survey (2001) Ann Surg, 234, pp. 549-55
Strasberg, S.M., Hertl, M., Soper, N.J., An analysis of the problem of biliary injury during laparoscopic cholecystectomy (1995) J Am Coll Surg, 189, pp. 101-125
Bachellier, P., Nakano, H., Weber, J.C., Surgical repair after bile duct and vascular injuries during laparoscopic cholecystectomy: When and how (2001) World J Surg, 25, pp. 1335-1345
Bismuth, H., Blumbgart, L.H., Post-operative strictures of the bile duct (1983) The Biliary Tract, pp. 209-218. , Churchill-Livingstone New York
Roslyn, J.J., Binns, G.S., Hughes, E.F., Saunders-Kirkwood, K., Zinner, M.J., Cates, J.A., Open cholecystectomy. a contemporary analysis of 42.474 patients (1993) Ann Surg, 218, pp. 129-137
Ragozzino, A., De Ritis, R., Mosca, A., Iaccarino, V., Imbriaco, M., Value of MR cholangiography in patients with iatrogenic bile duct injury after cholecystectomy (2004) Am J Roentgenol, 183, pp. 1567-1572
Bacha, E.A., Stieber, A.C., Galloway, J.R., Hunter, J.G., Non-biliary complication of laparoscopic cholecystectomy (1994) Lancet, 344, pp. 896-897
Usal, H., Sayad, P., Hayek, N., Hallak, A., Huie, F., Ferzli, G., Major vascular injuries during laparoscopic cholecystectomy. An institutional review of experience with 2589 procedures and literature review (1998) Surg Endosc, 12, pp. 960-962
Stewart, L., Robinson, T.N., Lee, C.M., Liu, K., Whang, K., Way, L.W., Right hepatic artery injury associated with laparoscopic bile duct injury: Incidence, mechanism, and consequences (2004) J Gastrointest Surg, 8, pp. 523-531
Schmidt, S.C., Settmacher, U., Langrehr, J.M., Neuhaus, P., Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy (2004) Surgery, 135, pp. 613-618
Koffron, A., Ferrario, M., Parsons, W., Nemcek, A., Saker, M., Abecassis, M., Failed primary management of iatrogenic biliary injury: Incidence and significance of concomitant hepatic arterial disruption (2001) Surgery, 130, pp. 722-731
Buell, J.F., Cronin, D.C., Funaki, B., Devastating and fatal complications associated with combined vascular and bile duct injuries during cholecystectomy (2002) Arch Surg, 137, pp. 703-710
Gupta, N., Solomon, H., Fairchild, R., Kaminski, D.L., Management and outcome of patients with combined bile duct and hepatic artery injuries (1998) Arch Surg, 133, pp. 176-181
Tzovaras, G., Dervenis, C., Vascular injuries in laparoscopic cholecystectomy: An underestimated problem (2006) Dig Surg, 23, pp. 370-374
Archer, S. B., Brown, D. W., Smith, C. D., Branum, G. D., Hunter, J. G., Bile duct injury during laparoscopic cholecystectomy. Results of a national survey (2001) Ann Surg, 234, pp. 549-55
Strasberg, S. M., Hertl, M., Soper, N. J., An analysis of the problem of biliary injury during laparoscopic cholecystectomy (1995) J Am Coll Surg, 189, pp. 101-125
Roslyn, J. J., Binns, G. S., Hughes, E. F., Saunders-Kirkwood, K., Zinner, M. J., Cates, J. A., Open cholecystectomy. a contemporary analysis of 42. 474 patients (1993) Ann Surg, 218, pp. 129-137
Bacha, E. A., Stieber, A. C., Galloway, J. R., Hunter, J. G., Non-biliary complication of laparoscopic cholecystectomy (1994) Lancet, 344, pp. 896-897
Schmidt, S. C., Settmacher, U., Langrehr, J. M., Neuhaus, P., Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy (2004) Surgery, 135, pp. 613-618
Buell, J. F., Cronin, D. C., Funaki, B., Devastating and fatal complications associated with combined vascular and bile duct injuries during cholecystectomy (2002) Arch Surg, 137, pp. 703-710
Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy
The aim of this study was to describe three cases of major vascular injuries after laparoscopic cholecystectomy depicted on magnetic resonance (MR) examination. Three female patients (mean age, 32 years; range, 22-39 years) were studied with clinical suspicion of bilio-vascular injuries after laparoscopic cholecystectomy. All MR examinations were performed within 24 h after the laparoscopic procedure. MR imaging was evaluated for major vascular injuries involving the arterial and portal venous system, for bile duct discontinuity, presence or absence of biliary dilation, stricture, excision injury, free fluid and collections. In the first patient, a type-IV Bismuth injury with associated intrahepatic bile ducts dilation was observed. Contrast-enhanced MR revealed lack of enhancement in the right hepatic lobe due to occlusion of the right hepatic artery and the right portal branch. This patient underwent right hepatectomy with hepatico-jejunostomy. In the other two cases, no visualization of the right hepatic artery and the right portal branch was observed on MR angiography. In the first case, the patient underwent right hepatectomy; in the second case, because of stable liver condition, the patient was managed conservatively. MR imaging combined with MR angiography and MR cholangiography can be performed emergently in patients with suspicion of bilio-vascular injury after laparoscopic cholecystectomy allowing the simultaneous evaluation of the biliary tree and the hepatic vascular supply that is essential for adequate treatment planning.
Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy
No results.
Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy