2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Nicola de’Angelis, Fausto Catena, Riccardo Memeo, Federico Coccolini, Aleix Martínez-Pérez, Oreste M. Romeo, Belinda De Simone, Salomone Di Saverio, Raffaele Brustia, Rami Rhaiem, Tullio Piardi, Maria Conticchio, Francesco Marchegiani, Nassiba Beghdadi, Fikri M. Abu-Zidan, Ruslan Alikhanov, Marc Antoine Allard, Niccolò Allievi, Giuliana Amaddeo, Luca AnsaloniRoland Andersson, Enrico Andolfi, Mohammad Azfar, Miklosh Bala, Amine Benkabbou, Offir Ben-Ishay, Giorgio Bianchi, Walter L. Biffl, Francesco Brunetti, Maria Clotilde Carra, Daniel Casanova, Valerio Celentano, Marco Ceresoli, Osvaldo Chiara, Stefania Cimbanassi, Roberto Bini, Raul Coimbra, Gian Luigi de’Angelis, Francesco Decembrino, Andrea De Palma, Philip R. de Reuver, Carlos Domingo, Christian Cotsoglou, Alessandro Ferrero, Gustavo P. Fraga, Federica Gaiani, Federico Gheza, Angela Gurrado, Ewen Harrison, Angel Henriquez, Stefan Hofmeyr, Roberta Iadarola, Jeffry L. Kashuk, Reza Kianmanesh, Andrew W. Kirkpatrick, Yoram Kluger, Filippo Landi, Serena Langella, Real Lapointe, Bertrand Le Roy, Alain Luciani, Fernando Machado, Umberto Maggi, Ronald V. Maier, Alain Chichom Mefire, Kazuhiro Hiramatsu, Carlos Ordoñez, Franca Patrizi, Manuel Planells, Andrew B. Peitzman, Juan Pekolj, Fabiano Perdigao, Bruno M. Pereira, Patrick Pessaux, Michele Pisano, Juan Carlos Puyana, Sandro Rizoli, Luca Portigliotti, Raffaele Romito, Boris Sakakushev, Behnam Sanei, Olivier Scatton, Mario Serradilla-Martin, Anne Sophie Schneck, Mohammed Lamine Sissoko, Iradj Sobhani, Richard P. ten Broek, Mario Testini, Roberto Valinas, Giorgos Veloudis, Giulio Cesare Vitali, Dieter Weber, Luigi Zorcolo, Felice Giuliante, Paschalis Gavriilidis, David Fuks, Daniele Sommacale

Research output: Contribution to journalReview articlepeer-review

79 Citations (Scopus)


Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Original languageEnglish
Article number30
JournalWorld Journal of Emergency Surgery
Issue number1
Publication statusPublished - Dec 2021


  • Antibiotic therapy
  • Biliary duct injury
  • Computed tomography
  • Guidelines
  • Laparoscopic cholecystectomy
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine


Dive into the research topics of '2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy'. Together they form a unique fingerprint.

Cite this