Iatrogenic Injury of Biliary Tree—Single-Centre Experience

Abstract

Cholecystolithiasis is among the most prevalent gastrointestinal disorders requiring surgical intervention, and iatrogenic damage to the bile tree is a severe complication. We aimed to present the frequency of bile duct injuries and how our facility handles these complications. We retrospectively analyzed bile duct injuries in patients undergoing surgery. We concentrated on factors such as sex, age, indications for surgery, type of surgery, primary procedure, bile tree injury, repair, and timing as well as early and late complications. There were 22 cases of bile duct injury in the studied material, primarily affecting women—15 individuals (68.2%). Eleven cases (45.7%) of acute cholecystitis were the primary reason for surgery, and an injury to the common bile duct that extended up to 2 cm from the common hepatic duct was the most common complication (European Association for Endoscopic Surgery grade 2). Roux-en-Y hepaticojejunostomy was the most common repair procedure in 14 cases (63.6%). Eleven patients (50%) experienced early complications following reconstruction surgery, whereas five patients (22.7%) experienced late complications. An annual mortality rate of 22.7% (five patients) was observed. Iatrogenic bile duct injury is a severe complication of surgical treatment for cholecystolithiasis. Reconstruction procedures are characterized by high complication rates and high mortality.

Major iatrogenic bile duct injury during elective cholecystectomy: a Czech population register-based study

“…However, bile duct injury, a serious complication of cholecystectomy may lead to late complications such as stenosis of the hepaticojejunostomy, followed by chronic cholangitis, biliary cirrhosis, portal hypertension, and liver failure. Studies indicate that the most common complications following bile duct reconstruction are recurrent cholangitis (11,4-23%), anastomotic leakage (5-10%), intra-abdominal abscess (14%), and anastomotic stricture (30%) [30][31][32]. Data from the Ministry of Justice of the Czech Republic, establish BDIs as the most common cause of legal liability, together with iatrogenic ureteral and recurrent laryngeal nerve injuries.…”