Management of Bile Duct Injuries: A 6-year Experience in a High Volume Referral Center

Abstract

Objectives The aim of our study was to determine operative and nonoperative treatments performed in bile duct injuries and the effect of a multidisciplinary approach on the treatment. Background Bile duct injuries may lead to morbidities such as biliary leakage, peritonitis, and mortality. Materials and methods A total of 83 patients with biliary complications (37 patients with iatrogenic bile duct injury referred to our clinic from other centers were also included in this study) were evaluated. Results Of the operated 6,663 patients, iatrogenic bile duct injury occurred in 46 (0.69%) of these patients. The most common type of injury was Strasberg type A injury, which was found in 48 (57.83%) patients. The time interval between the diagnosis and initiation of treatment after the operation was shorter in patients with an inserted cavity drainage catheter ( p < 0.05). Of the patients with bile duct injury, 32.6% received surgical and 62.6% endoscopic treatment, while 4.8% were followed-up without intervention. The rate of mortality was found to be 2.4%. Conclusion Time interval to diagnosis is of great importance for management of the patients. How to cite this article Çavuşoğlu SD, Doğanay M, Birben B, et al. Management of Bile Duct Injuries: A 6-year Experience in a High Volume Referral Center. Euroasian J Hepato-Gastroenterol 2020;10(1):22–26.

Iatrogenic Injury of Biliary Tree—Single-Centre Experience

“…The data in this study differ slightly from some of the available publications, where the majority of injuries happened during open surgery [28][29][30] because LC was already widespread during the observation period. Today, most cholecystectomies are performed laparoscopically, so BDIs typically occur during this type of intervention [24,28].…”

“…There are several possible reconstruction procedures for biliary tree injuries, the most common being endoscopic retrograde cholangiopancreatography (ERCP), primary end-toend anastomosis (with or without Kehr's T-tube drainage), choledochoduodenostomy, and choledochojejunostomy. Most centers prefer Roux-en-Y choledochojejunostomy to treat severe BDIs [22][23][24][25].…”

Experience of Treatment of Iatrogenic Bile Duct Injuries Following Laparoscopic Cholecystectomy in Tertiary Care Hospitals of Khyber Pukhtunkhwa

“…Çavuşoğlu SD et al described that epigastric pain was the common symptom among those patients suffering from iatrogenic bile duct injuries. [ 21] 15-35% of bile duct injuries are caused by local causes. Our study's prevalence of local risk factors (30.5%) was consistent with the percentages of local risk factors reported in the literature.…”