Ng JJ, Kow AWC. Pedicled omental patch as a bridging procedure for iatrogenic bile duct injury. World J Gastroenterol 2017; 23(36): 6741-6746 [PMID: 29085219 DOI: 10.3748/wjg.v23.i36.6741]
Corresponding Author of This Article
Jun Jie Ng, Senior Resident, Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. jun_jie_ng@nuhs.edu.sg
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 28, 2017; 23(36): 6741-6746 Published online Sep 28, 2017. doi: 10.3748/wjg.v23.i36.6741
Pedicled omental patch as a bridging procedure for iatrogenic bile duct injury
Jun Jie Ng, Alfred Wei Chieh Kow
Jun Jie Ng, Alfred Wei Chieh Kow, Department of Surgery, National University Hospital, Singapore 119074, Singapore
Author contributions: All the authors contributed to the acquisition of data, writing and revision of this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at the National University Hospital in Singapore.
Informed consent statement: The patient provided verbal consent authorizing use and disclosure of her protected health information prior to the writing of this manuscript.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jun Jie Ng, Senior Resident, Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. jun_jie_ng@nuhs.edu.sg
Telephone: +65-97375930 Fax: +65-67795678
Received: May 4, 2017 Peer-review started: May 4, 2017 First decision: June 6, 2017 Revised: July 22, 2017 Accepted: August 25, 2017 Article in press: August 25, 2017 Published online: September 28, 2017 Processing time: 144 Days and 6.5 Hours
Abstract
Iatrogenic bile duct injuries during cholecystectomy can present as fulminant intra-abdominal sepsis which precludes immediate repair or biliary reconstruction. We report the case of a 29-year-old female patient who sustained a bile duct injury after an open cholecystectomy in a neighboring country. She presented to our institution 22 d after initial surgery with septic shock and multiple intra-abdominal collections. Endoscopic retrograde cholangiography revealed a large common hepatic duct defect corresponding to a Strasberg type D bile duct injury. Definitive reconstruction such as a hepaticojejunostomy cannot be performed due to the presence of dense adhesions with infected and friable tissues. She underwent a combination of endoscopic biliary stenting and pedicled omental patch repair of the bile duct to control bile leak and sepsis as a bridging procedure to definite hepaticojejunostomy three months later.
Core tip: Iatrogenic bile duct injury is a challenging condition to treat. This case report describes a novel and innovative surgical technique, whereby a pedicled omental patch repair was performed as a bridging procedure to definitive repair such as a hepaticojejunostomy, in a patient who presented in a delayed fashion with severe intra-abdominal sepsis.
