Pattern and management of bile duct injuries presented to Hepatobiliary Unit of Shaikh Zayed Hospital Lahore.

Abstract

Objective: To find out the pattern and management of Bile Duct Injuries (BDIs) presented to Hepatobilliary unit. Study Design: Descriptive Cross Sectional. Setting: Hepatobiliary Unit, Shaikh Zayed Hospital Lahore. Period: November 1, 2022, to April 30, 2023. Methods: Total of 79 patients with Bile duct injuries were included. Demographic data and relevant investigations were performed. BDIs severity was classified using the Strausberg Classification. Patients underwent appropriate surgical interventions, with follow-up for period of 6 months postoperative complications. Results: The mean age was 39.89±10.01 yrs, primarily females (81%). BDI resulted from laparoscopic cholecystectomy in 44.3%, open cholecystectomy in 51.9%, and conversion to open surgery in 3.8% cases. Jaundice (58.2%), bile leak (38.0%), and itching (3.8%) were common presentations. Surgical procedures included hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). BDI classification revealed E2 (57.0%), E3 (36.7%), and E4 (6.3%) cases. Surgical site infection was observed in 11.4% of cases. Postoperatively 5.1% patients experienced anastomotic leaks and only the site of BDI was a significant factor for leak with the p value of <0.001. Conclusion: In conclusion the majority of BDIs were E2 (57.0%), E3 (36.7%), and E4 (6.3%).Procedure performed were hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). Anastomotic leaks were significantly linked to the site of BDI.