MANAGEMENT OF BILE DUCT INJURIES AFTER LAPAROSCOPIC CHOLECYSTECTOMY: A RETROSPECTIVE SINGLE-CENTER STUDY
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Abstract
Objective: To monitor the management and outcomes of bile duct injuries following laparoscopic cholecystectomy.
Methodology: This retrospective case series study was conducted from June 2020 to October 2021 in the Department of Hepato-Pancreatico-Biliary and Liver Transplant Surgery, Bahria International Hospital Lahore. A non-probability convenient sample technique was used to include 11 patients referred to our center after iatrogenic bile duct injuries (BDI) during cholecystectomy.
Results: All 11 patients (100%) included in the study had iatrogenic extrahepatic biliary duct injuries during their primary surgery for symptomatic gall stones, with 4 patients (36%) having type E injury, 4 (36%) having type A leak, and 3 patients (27%) having type D leak according to the Strasberg classification. Endoscopic management was utilized in 6 patients (55%) with type A and D injuries, while the percutaneous intervention was used in 1 patient (9%), and hepaticojejunostomy was performed in 3 patients (27%). One patient (9%) developed secondary biliary cirrhosis and was advised for a liver transplant.
Conclusion: Laparoscopic cholecystectomy is a generally safe procedure, but it can result in bile duct injuries. Suspected or diagnosed cases of bile duct injuries require referral to a specialist center for proper management. The treatment of such injuries is complex, and inadequate management can lead to secondary biliary cirrhosis and liver failure.
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