Management of Bile Duct Injury Following Cholecystectomy

  • Bala Ram Malla Department of Surgery, Dhulikhel Hospital, Banepa, Kavre, Nepal
  • Nripesh Rajbhandari Department of Surgery, Dhulikhel Hospital, Banepa, Kavre, Nepal
  • Robin Man Karmacharya Department of Surgery, Dhulikhel Hospital, Banepa, Kavre, Nepal
DOI: https://doi.org/10.33314/jnhrc.v18i2.1579

Abstract

Background: Laparoscopic cholecystectomy is responsible for 80-85% of the bileduct injury, and twice as frequentcompared to open cholecystectomy.Injury affects the quality of life and overall survival of the patient. The management of these injuries is complex and challenging. There are few locally published reports regarding management of bile duct injury. The objective of this study is to evaluate the management of bile duct injury and its outcome
Methods: This retrospective study includes patients bile duct injury following cholecystectomy who were managed at Dhulikhel Hospital, Nepal, during January 2014 to December 2016. The clinical features, type of injuries(Strasberg classification) management, outcome (as per McDonald and colleague grading system) and follow up were analyzed descriptively.
Results: Out of 35 bile duct injuries,only 3 (8.57%)occurred following open cholecystectomy. Three (8.7%) cases of bile duct injury were diagnosed intraoperatively and had primary biliary anastomosis over T-tube. Five (14.28%) were diagnosed postoperatively and underwent Roux-en-y hepatojejunostomy 6 weeks after index surgery. And, 27(77.14%) with type A injuries were treated by endoscopic retrograde cholangio-pancreatography and stenting. After surgical repair, 1 (2.85%) had transient biliary leak. One patient had grade B outcome. During 18 months follow up, no stricture or cholangitis were observed.
Conclusions: Bile duct injury with intact continuity of the duct can be successfully managed with endoscopic stenting of the biliary tree. Intraoperative diagnosis of bile duct injury and immediate surgical management has good outcome.
Keywords: Bile duct injury; cholecystectomy; repair; strasberg classification

Published
2020-09-07
How to Cite
MallaB. R., RajbhandariN., & KarmacharyaR. M. (2020). Management of Bile Duct Injury Following Cholecystectomy. Journal of Nepal Health Research Council, 18(2), 214-218. https://doi.org/10.33314/jnhrc.v18i2.1579
Issue
Vol. 18 No. 2 (2020): Vol. 18 No. 2 Issue 47 Apr-Jun 2020
Section
Original Article

Copyright (c) 2020 Bala Ram Malla, Nripesh Rajbhandari, Robin Man Karmacharya

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Journal of Nepal Health Research Council JNHRC allows to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. Copyright is retained by author. The JNHRC work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).