2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy
Creators: name: De’Angelis, Nicola
name: Catena, Fausto
name: Memeo, Riccardo
name: Coccolini, Federico
name: Martínez-Pérez, Aleix
name: Romeo, Oreste M.
name: De Simone, Belinda
name: Di Saverio, Salomone
name: Brustia, Raffaele
name: Rhaiem, Rami
name: Piardi, Tullio
name: Conticchio, Maria
name: Marchegiani, Francesco
name: Beghdadi, Nassiba
name: Abu-Zidan, Fikri M.
name: Alikhanov, Ruslan
name: Allard, Marc-Antoine
name: Allievi, Niccolò
name: Amaddeo, Giuliana
name: Ansaloni, Luca
name: Andersson, Roland
name: Andolfi, Enrico
name: Azfar, Mohammad
name: Bala, Miklosh
name: Benkabbou, Amine
name: Ben-Ishay, Offir
name: Bianchi, Giorgio
name: Biffl, Walter L.
name: Brunetti, Francesco
name: Carra, Maria Clotilde
name: Casanova, Daniel
name: Celentano, Valerio
name: Ceresoli, Marco
name: Chiara, Osvaldo
name: Cimbanassi, Stefania
name: Bini, Roberto
name: Coimbra, Raul
name: Luigi De’Angelis, Gian
name: Decembrino, Francesco
name: De Palma, Andrea
name: De Reuver, Philip R.
name: Domingo, Carlos
name: Cotsoglou, Christian
name: Ferrero, Alessandro
name: Fraga, Gustavo P.
name: Gaiani, Federica
name: Gheza, Federico
name: Gurrado, Angela
name: Harrison, Ewen
name: Henriquez, Angel
name: Hofmeyr, Stefan
name: Iadarola, Roberta
name: Kashuk, Jeffry L.
name: Kianmanesh, Reza
name: Kirkpatrick, Andrew W.
name: Kluger, Yoram
name: Landi, Filippo
name: Langella, Serena
name: Lapointe, Real
name: Le Roy, Bertrand
name: Luciani, Alain
name: Machado, Fernando
name: Maggi, Umberto
name: Maier, Ronald V.
name: Mefire, Alain Chichom
name: Hiramatsu, Kazuhiro
name: Ordoñez, Carlos
name: Patrizi, Franca
name: Planells, Manuel
name: Peitzman, Andrew B.
name: Pekolj, Juan
name: Perdigao, Fabiano
name: Pereira, Bruno M.
name: Pessaux, Patrick
name: Pisano, Michele
name: Puyana, Juan Carlos
name: Rizoli, Sandro
name: Portigliotti, Luca
name: Romito, Raffaele
name: Sakakushev, Boris
name: Sanei, Behnam
name: Scatton, Olivier
name: Serradilla-Martin, Mario
name: Schneck, Anne-Sophie
name: Sissoko, Mohammed Lamine
name: Sobhani, Iradj
name: Ten Broek, Richard P.
name: Testini, Mario
name: Valinas, Roberto
name: Veloudis, Giorgos
name: Vitali, Giulio Cesare
name: Weber, Dieter
name: Zorcolo, Luigi
name: Giuliante, Felice
name: Gavriilidis, Paschalis
name: Fuks, David
name: Sommacale, Daniele
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Review
Laparoscopic cholecystectomy
Biliary duct injury
Magnetic resonance imaging
Antibiotic therapy
Computed tomography
Guidelines

description: Abstract: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.