Frequency and outcomes of liver resection in patient presenting with complex bile duct injury following cholecystectomy in hepatobilliary unit: A cross-sectional study.

Abstract

Objective: To assess frequency of hepatectomy for bile duct injuries at a hepatobiliary unit and post-operative outcomes. Study Design: Cross-sectional Comparative study. Setting: Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore. Period: January 2022 to July 2022. Methods: Nonprobability consecutive sampling method included diagnosed 79 BDIs patients. Ultrasound and MRCP aided injury site identification, with surgical decisions made by consultants. Outcomes, like postoperative bile leaks, surgical site infections, and in-hospital deaths, were followed for six months. SPSS 23 handled statistical analysis. Results: Among 79 BDIs, mean age was 39.9±9.96, with 81% females and 19% males. 51.9% of BDIs had previous open cholecystectomy procedure while 44.3% had laparoscopic cholecystectomy. Most cases (88.6%) had no arterial injuries; 11.4% had right hepatic artery injuries. Hepatectomy was done in 22.8%, and 77.2% had hepaticojejunostomy. No hepatectomy-related deaths were observed. Both procedures had 12.5% SSIs. Hepatectomy had 12.5% post-operative leaks, but no strictures in the 6-month follow-up. Conclusion: 22.8% of BDI cases received liver resection, mainly with concomitant arterial injuries. Post-operative complications, including SSIs and leaks, were comparable. Surgical history influenced procedure choice, but in-hospital mortality was low, with no strictures reported within six months post-surgery.