Clinical presentation, types and treatment outcomes of Bile Duct Injuries (BDI) in laparoscopic cholecystectomy.

  • Uzair Ahmad HMC, Peshawar.
  • Yousaf Jan HMC, Peshawar.
  • Muhammad Uzair North West General Hospital, Peshawar.
Keywords: Cholecystectomy, Critical View, Hepatico-Jejunostomy, Peritonitis

Abstract

Objectives: To study the types of Biliary injuries (BDIs), their timing and clinical presentation, diagnosis and treatment outcomes in patients undergoing laparoscopic cholecystectomy. Study Design: Descriptive study. Setting: Department of General Surgery Hayatabad Medical Complex (HMC) Peshawar. Period: From October 2017 to October 2018. Materials & Methods: including 32 patients with biliary duct injuries (BDIs). Results: This study included 32 patients with BDI, 28 patients were referred to HMC and 4 patients had their primary operation at Department of General Surgery HMC Peshawar. There were 23 females and 9 males with a mean age of 47 years (range, 20–65 years). After diagnostic workup, the type of BDIs was classified according to the Strasberg classification. As for BDI, 4(12.5%) patients had a leak related to the cystic duct (Type A injury).In 11(34.3%) patients, there was lateral injury of CBD (Type D injury). In 15(46.8%) patients, there was complete transection of CBD (Type E injury). In 2 (6.2%) patients, it was impossible to determine the cause of bile leak which was assumed to be related to aberrant ducts although this was difficult to prove. Conclusion: Laparoscopic cholecystectomy is best if done with proper training and expertise otherwise it can lead to biliary injury thus turning the patient into a "biliary cripple". They mainly result from anatomical variations and cognitive misinterpretation of anatomy .Biliary injuries can be prevented to some extent if principles of laparoscopic surgery are followed.

Author Biographies

Uzair Ahmad, HMC, Peshawar.

FCPS Gen Surgery

Specialist Registrar Surgery

 

Yousaf Jan, HMC, Peshawar.

FCPS Gen Surgery

Assistant Professor Surgery

 

Muhammad Uzair, North West General Hospital, Peshawar.

FCPS Gen Surgery

Senior Registrar Surgery

 

Published
2020-02-10