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Chicago 2009 Video – Robotic repair of biliary injuries

Chicago 2009 Video – Robotic repair of biliary injuries

F. Elli

Background/Hypothesis
Common bile duct (CBD) injuries represent the most important complication of laparoscopic cholecystectomy. A robotic
repair of iatrogenic CBD injury is showed in this video.

Materials & Methods
A 20 year old patient underwent a laparoscopic cholecystectomy for symptomatic gallstones and discharged home the same
day. She returned to the hospital 48 hours after surgery complaining
of abdominal pain. A CT scan performed showed a large abdominal fluid collection compatible with a biloma. An ERCP
showed an interruption of the bile duct with contrast extravasation. The patient was transferred to our institution where the
fluid collection was drained percutaneously. A robotic repair of CBD injury with da Vinci robotic system was performed.

Results
A surgical reconstruction by a double intrahepatic epatico-jejunostomy was carried out robotically. Surgery lasted 460 minutes
with minimal blood loss. The patient was discharged in good condition at postoperative day six.

Conclusions
Minimally invasive repair of CBD injuries is technically feasible. Larger experience and longer follow up are required to validate
this initial report.

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