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2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

2021; BioMed Central; Volume: 16; Issue: 1 Linguagem: Inglês

10.1186/s13017-021-00369-w

1749-7922

Nicola de’Angelis, Fausto Catena, Riccardo Memeo, Federico Coccolini, Aleix Martínez‐Pérez, Oreste Romeo, Belinda De Simone, Salomone Di Saverio, Raffaele Brustia, Rami Rhaiem, Tullio Piardi, Maria Conticchio, Francesco Marchegiani, Nassiba Beghdadi, Fikri M. Abu‐Zidan, Ruslan Alikhanov, Marc-Antoine Allard, Niccolò Allievi, Giuliana Amaddeo, Luca Ansaloni, Roland E. Andersson, Enrico Andolfi, Mohammad Azfar, Miklosh Bala, Amine Benkabbou, Offir Ben‐Ishay, Giorgio Bianchi, Walter L. Biffl, Francesco Brunetti, Maria Clotilde Carrà, Daniel Casanova, Valerio Celentano, Marco Ceresoli, Osvaldo Chiara, Stefania Cimbanassi, Roberto Bini, Raúl Coimbra, Gian Luigi de’Angelis, F. Decembrino, Andrea De Palma, Philip R. de Reuver, Carlos Domingo del Pozo, Christian Cotsoglou, Alessandro Ferrero, Gustavo Pereira Fraga, Federica Gaiani, Federico Gheza, Angela Gurrado, Ewen M. Harrison, Angel Henriquez, Stefan Hofmeyr, Roberta Iadarola, Jeffry L. Kashuk, Réza Kianmanesh, Andrew W. Kirkpatrick, Yoram Kluger, Filippo Landi, Serena Langella, Réal Lapointe, Bertrand Le Roy, Alain Luciani, Fernando Osni Machado, U. Maggi, Ronald V. Maier, Alain Chichom‐Mefire, Kazuhiro Hiramatsu, Carlos A. Ordóñez, Franca Patrizi, Manuel Planells, Andrew B. Peitzman, Juan Pekolj, Fabiano Perdigão, Bruno M. Pereira, Patrick Pessaux, Michele Pisano, Juan Carlos Puyana, Sandro Rizoli, Luca Portigliotti, Raffaele Romito, Boris Sakakushev, Behnam Sanei, Olivier Scatton, Mario Serradilla‐Martín, Anne‐Sophie Schneck, Mohammed Lamine Sissoko, Iradj Sobhani, Richard P. G. ten Broek, Mario Testini, Roberto Valiñas, Giorgos Veloudis, Giulio Cesare Vitali, Dieter Weber, Luigi Zorcolo, Felice Giuliante, Paschalis Gavriilidis, David Fuks, Danièle Sommacale,

Pediatric Hepatobiliary Diseases and Treatments

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.