Our Summary

This research paper is about the most common serious complication that can occur during a laparoscopic cholecystectomy, which is a type of surgery to remove the gallbladder. This complication is called bile duct injury. To address this problem, a group of experts from five different surgical societies got together to review existing research and come up with a list of recommendations. These recommendations are based on the best available evidence and, when that wasn’t possible, on the expert opinion of the group. The recommendations were then presented to a larger group of experts who voted on them. The group reached consensus on almost all of the recommendations, although most of them were conditional due to the evidence not being very strong. The two strongest recommendations were to use a special imaging technique during surgery if there’s uncertainty about the anatomy or suspicion of a bile duct injury, and to refer patients with a confirmed or suspected bile duct injury to a specialist. The aim of these recommendations is to reduce the number of bile duct injuries that occur during this type of surgery, and to improve patient outcomes. The paper suggests that these recommendations could also be used to guide future research and education efforts.

FAQs

  1. What is the most common serious complication during a laparoscopic cholecystectomy?
  2. What are the two strongest recommendations to address bile duct injury during this type of surgery?
  3. How were the recommendations for preventing bile duct injury during laparoscopic cholecystectomy developed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to follow all pre-operative instructions given by the surgical team, such as fasting before the procedure and stopping certain medications as directed. Following these instructions can help reduce the risk of complications during surgery.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, gallbladder polyps, gallbladder inflammation (cholecystitis), gallbladder sludge, or gallbladder cancer. Additionally, patients who have recurrent episodes of biliary colic, pancreatitis, or jaundice due to gallstones may also be recommended for this surgery. It is important for patients to discuss their specific condition and symptoms with their healthcare provider to determine if laparoscopic cholecystectomy is the best treatment option for them.

Timeline

  • Before laparoscopic cholecystectomy:
  1. Patient experiences symptoms of gallbladder disease such as abdominal pain, nausea, vomiting, and bloating.
  2. Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the presence of gallstones or inflammation in the gallbladder.
  3. Surgeon recommends laparoscopic cholecystectomy as the treatment option for the patient.
  4. Patient undergoes pre-operative evaluation and preparation for surgery.
  • During laparoscopic cholecystectomy:
  1. Patient is placed under general anesthesia.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the gallbladder.
  3. Surgeon removes the gallbladder using specialized surgical instruments.
  4. Procedure typically lasts 1-2 hours.
  • After laparoscopic cholecystectomy:
  1. Patient is monitored in the recovery room before being discharged home the same day or after a short overnight stay.
  2. Patient may experience mild pain and discomfort at the incision sites.
  3. Patient is advised to follow a specific diet and activity guidelines to aid in recovery.
  4. Patient may return to normal activities within a week or two.
  5. Follow-up appointments are scheduled to monitor the patient’s recovery and address any concerns or complications.

What to Ask Your Doctor

  1. What is laparoscopic cholecystectomy and why is it recommended for me?
  2. What are the risks and benefits of undergoing this surgery?
  3. How many laparoscopic cholecystectomies have you performed and what is your success rate?
  4. What is your plan for managing any potential complications during or after the surgery?
  5. How long will the recovery process take and what can I expect in terms of pain and discomfort?
  6. What are the potential long-term effects of having my gallbladder removed?
  7. Are there any alternative treatment options for my condition?
  8. How will my diet and lifestyle need to change after the surgery?
  9. How often will I need to follow up with you after the surgery?
  10. Can you provide me with any resources or information to help me prepare for the surgery and recovery process?

Reference

Authors: Brunt LM, Deziel DJ, Telem DA, Strasberg SM, Aggarwal R, Asbun H, Bonjer J, McDonald M, Alseidi A, Ujiki M, Riall TS, Hammill C, Moulton CA, Pucher PH, Parks RW, Ansari MT, Connor S, Dirks RC, Anderson B, Altieri MS, Tsamalaidze L, Stefanidis D; Prevention of Bile Duct Injury Consensus Work Group. Journal: Surg Endosc. 2020 Jul;34(7):2827-2855. doi: 10.1007/s00464-020-07568-7. Epub 2020 May 12. PMID: 32399938