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Invited Commentary

Invited Commentary Abstract Stewart and Way analyzed 90 patients with laparoscopic bile duct injuries with respect to total duration of illness. Only 18% of the initial attempts at repair and 0% of second attempts at repair by the initial surgeon were successful. In contrast, 94% of the repairs performed by very experienced biliary tract surgeons were successful. A primary end-to-end repair over a T tube was unsuccessful in every case of the classic bile duct injury,1 and balloon dilatations uniformly were unsuccessful. The authors conclude that surgeons who specialize in the repair of bile duct injuries achieve much better results than those with less experience. Nonsurgical treatment is generally unsuccessful. Both unsuccessful methods substantially increase the duration of disability. One might challenge these data by saying that the data are self-serving, that the tertiary surgeon only sees the failures, and that most injuries in the community are repaired successfully there. The latter References 1. Davidoff AM, Pappas TN, Murray EA, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy . Ann Surg . 1992;215:196-202.Crossref 2. Branum GD, Schmitt C, Baillie J, et al. Management of major biliary complications after laparoscopic cholecystectomy . Ann Surg . 1993;217:532-541.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Invited Commentary

Archives of Surgery , Volume 130 (10) – Oct 1, 1995

Invited Commentary

Abstract

Abstract Stewart and Way analyzed 90 patients with laparoscopic bile duct injuries with respect to total duration of illness. Only 18% of the initial attempts at repair and 0% of second attempts at repair by the initial surgeon were successful. In contrast, 94% of the repairs performed by very experienced biliary tract surgeons were successful. A primary end-to-end repair over a T tube was unsuccessful in every case of the classic bile duct injury,1 and balloon dilatations uniformly were...
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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1995.01430100107020
Publisher site
See Article on Publisher Site

Abstract

Abstract Stewart and Way analyzed 90 patients with laparoscopic bile duct injuries with respect to total duration of illness. Only 18% of the initial attempts at repair and 0% of second attempts at repair by the initial surgeon were successful. In contrast, 94% of the repairs performed by very experienced biliary tract surgeons were successful. A primary end-to-end repair over a T tube was unsuccessful in every case of the classic bile duct injury,1 and balloon dilatations uniformly were unsuccessful. The authors conclude that surgeons who specialize in the repair of bile duct injuries achieve much better results than those with less experience. Nonsurgical treatment is generally unsuccessful. Both unsuccessful methods substantially increase the duration of disability. One might challenge these data by saying that the data are self-serving, that the tertiary surgeon only sees the failures, and that most injuries in the community are repaired successfully there. The latter References 1. Davidoff AM, Pappas TN, Murray EA, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy . Ann Surg . 1992;215:196-202.Crossref 2. Branum GD, Schmitt C, Baillie J, et al. Management of major biliary complications after laparoscopic cholecystectomy . Ann Surg . 1993;217:532-541.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1995

References