Management of descending duodenal injuries secondary to laparoscopic cholecystectomy

Mario Testini, Giuseppe Piccinni, Germana Lissidini, Beatrice Di Venere, Angela Gurrado, Elisabetta Poli, Nicola Brienza, Antonio Biondi, Luigi Greco, Michele Nacchiero

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To report our experience of managing patients affected by descending duodenal injuries secondary to laparoscopic cholecystectomy and to review the literature. Methods: Analysis of 5 cases of descending duodenal injury as a consequence of laparoscopic cholecystectomy managed between June 1992 and September 2006. Results: The median age was 59 (range 49-67) years.In all cases an emergency laparotomy showed an injury to the descending duodenum. Two patients underwent direct suture of the duodenum and external biliary drainage through a T-tube, 1 case underwent a duodenojejunostomy and in another a duodenopancreatectomy. The latter patient underwent drainage of the duodenum with a Petzer tube, followed 5 days later by gastric resection, closure of the duodenal stump and repair of the duodenal wound by suture. The median postoperative stay was 45 days and 1 patient died. Conclusion: Descending duodenal injuries are extremely rare complications of laparoscopic cholecystectomy with potentially fatal consequences if not promptly recognized and treated. The site of the descending duodenal injury is important for determining the surgical approach.

Original languageEnglish
Pages (from-to)12-15
Number of pages4
JournalDigestive Surgery
Volume25
Issue number1
DOIs
Publication statusPublished - Apr 2008

Keywords

  • Descending duodenal injury
  • Descending duodenum
  • Emergency laparotomy
  • Laparoscopic cholecystectomy
  • Laparoscopic cholecystectomy, complications

ASJC Scopus subject areas

  • Surgery

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