Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2022; 14(2): 442-455
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.442
Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review
Patryk Kambakamba, Sinead Cremen, Beat Möckli, Michael Linecker
Patryk Kambakamba, Sinead Cremen, Department of HPB and Transplant Surgery, St. Vincent’s University Hospital Dublin, Dublin d04 T6F4, Ireland
Patryk Kambakamba, Department of Surgery, Cantonal Hospital Glarus, Glarus 8750, Switzerland
Beat Möckli, Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva 1205, Switzerland
Michael Linecker, Department of Surgery and Transplantation, University Medical Center Schleswig Holstein, Kiel 24105, Germany
Author contributions: Kambakamba P, Cremen S, Möckli B, and Linecker M all contributed in creating this manuscript.
Conflict-of-interest statement: All the authors declare no conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Patryk Kambakamba, MD, Surgeon, Department of HPB and Transplant Surgery, St. Vincent’s University Hospital Dublin, Elm Park Dublin 4, Dublin d04 T6F4, Ireland. patryk.kambakamba@usz.ch
Received: June 19, 2021
Peer-review started: June 19, 2021
First decision: July 16, 2021
Revised: October 2, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: February 27, 2022
Processing time: 247 Days and 20.8 Hours
Abstract
BACKGROUND

The surgical management of bile duct injuries (BDIs) after laparoscopic cholecystectomy (LC) is challenging and the optimal timing of surgery remains unclear. The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature.

AIM

To assess timing of surgical repair of BDI and postoperative complications.

METHODS

The MEDLINE, EMBASE, and The Cochrane Library databases were systematically screened up to August 2021. Risk of bias was assessed via the Newcastle Ottawa scale. The primary outcomes of this review included the timing of BDI repair and postoperative complications.

RESULTS

A total of 439 abstracts were screened, and 24 studies were included with 15609 patients included in this review. Of the 5229 BDIs reported, 4934 (94%) were classified as major injury. Timing of bile duct repair was immediate (14%, n = 705), early (28%, n = 1367), delayed (28%, n = 1367), or late (26%, n = 1286). Standardization of definition for timing of repair was remarkably poor among studies. Definitions for immediate repair ranged from < 24 h to 6 wk after LC while early repair ranged from < 24 h to 12 wk. Likewise, delayed (> 24 h to > 12 wk after LC) and late repair (> 6 wk after LC) showed a broad overlap.

CONCLUSION

The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC. This finding indicates an urgent need for a standardized reporting system of BDI repair.

Keywords: Bile duct injury, Major bile duct injury, Laparoscopic cholecystectomy, Surgical repair, Immediate repair, Early repair, Delayed repair, Late repair, Biliary reconstruction, Standardization of bile duct injury repair reporting

Core Tip: Bile duct injury after laparoscopic cholecystectomy is a relevant iatrogenic complication, which urgently needs attention. In this systematic review, we would like to focus on surgical repair and particularly on the timing of repair. This literature search reveals that the ideal timing of repair is reported remarkable poorly, indicating an urgent need for standardization to better direct treatment of this condition.