A study of incidence and different treatment modalities for bile duct injury and bile leakage in 200 cases of laparoscopic cholecystectomy

Gohel, Jayesh; Sharma, Dinesh Dutt; Patel, Nainesh B; Raswan, Uday Singh; Patil, Salil

doi:10.5455/ijmsph.2016.22102015225

Cited by 1 publication

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“…9,10 Diagnostic imaging's have important role in diagnosis of BDI. 9,10 Early recognition and prompt treatment of BDI is crucial for successful outcome and it should be managed in specialized centers 11 Most cases of BDI are now treated with endoscopic procedures while others still require open surgical reconstruction. 7,8 The aim of this study was to determine the types of BDI, their timing and clinical presentation, diagnosis and treatment outcomes in patients undergoing laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation, types and treatment outcomes of Bile Duct Injuries (BDI) in laparoscopic cholecystectomy.

Ahmad¹,

Jan²,

Uzair³

2020

TPMJ

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Objectives: To study the types of Biliary injuries (BDIs), their timing and clinical presentation, diagnosis and treatment outcomes in patients undergoing laparoscopic cholecystectomy. Study Design: Descriptive study. Setting: Department of General Surgery Hayatabad Medical Complex (HMC) Peshawar. Period: From October 2017 to October 2018. Materials & Methods: including 32 patients with biliary duct injuries (BDIs). Results: This study included 32 patients with BDI, 28 patients were referred to HMC and 4 patients had their primary operation at Department of General Surgery HMC Peshawar. There were 23 females and 9 males with a mean age of 47 years (range, 20–65 years). After diagnostic workup, the type of BDIs was classified according to the Strasberg classification. As for BDI, 4(12.5%) patients had a leak related to the cystic duct (Type A injury).In 11(34.3%) patients, there was lateral injury of CBD (Type D injury). In 15(46.8%) patients, there was complete transection of CBD (Type E injury). In 2 (6.2%) patients, it was impossible to determine the cause of bile leak which was assumed to be related to aberrant ducts although this was difficult to prove. Conclusion: Laparoscopic cholecystectomy is best if done with proper training and expertise otherwise it can lead to biliary injury thus turning the patient into a "biliary cripple". They mainly result from anatomical variations and cognitive misinterpretation of anatomy .Biliary injuries can be prevented to some extent if principles of laparoscopic surgery are followed.

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