Management of Iatrogenic Bile Duct Injuries Following Cholecystectomy

Abstract

Objective: The objective of the study is to analyzed Iatrogenic bile duct injuries (IBDI) following laparoscopic and open cholecystectomies and their management.

Study Design: Observational study

Place and Duration of Study: This study was conducted at Surgical Unit, Civil Hospital, Karachi from January 2009 to December 2015.

Materials and Methods: The study includes twenty three patients by convenient sampling technique. Patients with common bile duct (CBD) injury following open & laparoscopic cholecystectomy were included whereas patients with CBD injury following hepatobiliary pancreatic malignancy, gastrectomy, abdominal trauma, CBD exploration due to stone disease/stricture were excluded from the study.

Results: A total of twenty three patients, 20 (87%) female and 03(13%) male were included in the study after IBDI following laparoscopic/open cholecystectomy. Mean age was 42.65 (range: 25-65). Emergency department admission was common mode of admission (15 patients, 65.2%). Whereas mean time to referral following injury was 4.87 (median 5) days. Roux-en–Y hepatojejunostomy were the commonest surgical procedure performed 14(60.2%) patients. Major complications noted were stricture at anastomasis site (1 patient, 4.3%) and liver abscess (1 patient, 4.3%) but overall no mortality.

Conclusion: Early diagnosis and treatment of iatrogenic bile duct injury result in reduce morbidity and mortality.