Surgical Management of Post Cholecystectomy Biliary Injuries: A Center Experience

Faculty Medicine Year: 2023
Type of Publication: ZU Hosted Pages:
Authors:
Journal: Zagazig University Medical Journal Zagazig University, Faculty of Medicine Volume:
Keywords : Surgical Management , Post Cholecystectomy Biliary Injuries:    
Abstract:
Background: Bile duct injury (BDI) is the nightmare sequelae following gallbladder surgery. Ranging from 0.3 to 1.5%. Methods: A retrospective study was done from October 2010 to October 2020; including 162 patients who suffered from biliary complications post-open and laparoscopic cholecystectomy. All the patients were managed surgically and followed up for at least 2 years in the advanced hepato-pancreatico-biliary center, at Zagazig University, Egypt. Results: Most of our patients were females (69.75%) with median age (of 33±12.3) years. Biliary leakage was presented in 71 (43.83%) patients, ligated CHD presented in 59 (36.42%) patients, long-term biliary stricture was in 29 (17.9%) patients and haemobilia was in three patients. Roux-en-Y hepaticojejunostomy (HJ) was the procedure in all patients. No mortality was reported in our patients while post-operative complications were detected in 31 (19.13%) patients. Post-operative HJ stricture was 13/162 (8.02%) patients. Percutaneous Transhepatic Biliary Drainage (PTBD) was used successfully in managing anastomotic stricture in 11 patients. Conclusions: Iatrogenic BDIs represent catastrophic sequelae post-cholecystectomy. Proper management requires early diagnosis, management of intra-abdominal fluid collection and infection, nutritional support, a multi-disciplinary team, and an expert hepato-biliary surgeon.
   
     
 
       

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