Laparoscopic Cholecystectomy Versus Percutaneous Catheter Drainage for Acute Cholecystitis in High Risk Patients (CHOCOLATE): Multicentre Randomised Clinical Trial

Loozen CS, et al. Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial. BMJ. 2018 Oct 8; 363:k3965.

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what this study adds

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Warren Lecture: Articles of interest

Dr. Steven M. Strasberg referenced the following citations during his presentation, “Understanding and Preventing Bile Duct Injury” on November 14, 2019.

Cho JY, Baron TH, Carr-Locke DL, Chapman WC, Costamagna G, de Santibanes E, Dominguez Rosado I, Garden OJ, Gouma D, Lillemoe KD, Angel Mercado M, Mullady DK, Padbury R, Picus D, Pitt HA, Sherman S, Shlansky-Goldberg R, Tornqvist B, Strasberg SM. Proposed standards for reporting outcomes of treating biliary injuries. HPB (Oxford). 2018 Apr;20(4):370-378.

Strasberg SM. A three-step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review. J Hepatobiliary Pancreat Sci. 2019 Apr;26(4):123-127.

Strasberg SM. Error traps and vasculo-biliary injury in laparoscopic and open  cholecystectomy. J Hepatobiliary Pancreat Surg. 2008;15(3):284-92.

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Bile duct injuries: classification & repair

One discussion last week included classification of bile duct injuries.

Seeras K, Kalani AD. Bile Duct Repair. 2018 Nov 24. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.

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Clinical Significance: “Many major bile duct injuries will require surgical repair. There are many described techniques for complex biliary injury repairs including primary repair or primary end to end anastomosis of bile ducts, choledochoduodenostomy, and cholecystojejunostomy. The most popular surgical repair is the Roux-en-Y hepaticojejunostomy. This operation has been consistently superior to the other methods when considering long-term outcomes. There are many different techniques described to perform an RYHJ, and the operating surgeon should choose the method with which he or she is most comfortable or experienced.”

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