Ann Hepatobiliary Pancreat Surg.  2019 Feb;23(1):84-86. 10.14701/ahbps.2019.23.1.84.

Intraoperatively malpositioned stent as a complication of common bile duct injury during laparoscopic cholecystectomy

• Özdemir T
• Schmitt A
• Cesaretti
• Zarzavadjian Le Bian A
• Jiao LR

• KMID: 2439053
• DOI: http://doi.org/10.14701/ahbps.2019.23.1.84

Abstract

Injuries occurring during laparoscopic bile duct exploration in the course of laparoscopic cholecystectomy may represent threatening complications and lead to inappropriate management. We present a case of patient with biliary colic who underwent laparoscopic cholecystectomy. During the procedure, a common bile duct injury occurred, compelling conversion to open approach, and the patient was treated using a manually inserted biliary stent. She was referred with severe right upper quadrant pain six weeks after the surgery. Investigation with endoscopic retrograde cholangiopancreatography showed a malpositioned biliary stent with completely extra-biliary trajectory. This is thought to be the first description of a malpositioned common bile duct stent through the common biliary duct as a complication of the commonly performed surgical procedure of bile duct exploration.

Keyword

Cholecystectomy; Laparoscopic cholecystectomy; Bile duct injury; Malpositioned biliary stent; Laparoscopy

MeSH Terms

Bile Ducts
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy
Cholecystectomy, Laparoscopic*
Colic
Common Bile Duct*
Humans
Laparoscopy
Stents*

Figure

• 

  Fig. 1 X-ray and CT-scan. Imaging showing no abnormality regarding the abdominal X-ray (A) but a malpositioned biliary stent at abdominal CT-scan (B). The white arrow shows the biliary stent.

• 

  Fig. 2 Endoscopic Retrograde CholangioPancreatography. Endoscopic Retrograde cholangiopancreatography (A: front side; B: from the side) showing the biliary stent (white arrow) outside the dilated common bile duct (grey arrow).

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