Iatrogenic Bile Duct Injury Following Cholecystectomy, Surgical Management and Outcome: A Single Center Experience

Faraidon Faiq  Ahmed; Tayeb Sabir  Kareem; Karzan Seerwan  Abdulla; Qalandar Hussein Karim

doi:10.56056/amj.2018.32

Authors

Faraidon Faiq Ahmed Trainee of KBMS Digestive surgery, Department of digestive and liver surgery, Rizgari Teaching Hospital, Erbil, KRG, Iraq
Tayeb Sabir Kareem Professor of surgery, FIBMS, FICS, FACS, FRCS(Lon.). Director of digestive surgery in KBMS. Rizgari Teaching Hospital, Erbil, KRG, Iraq.
Karzan Seerwan Abdulla PDF in HPB surgery, FIBMS, MRCS. Department of digestive and liver surgery, Shoersh and Shar Teaching Hospitals, Sulaymaniyah, KRG, Iraq
Qalandar Hussein Karim Consultant in GIT Surgery, MBChB, FRCS (Glasg), FACS. Department of digestive and liver surgery, Shoersh and Shar Teaching Hospitals, Sulaymaniyah, KRG, Iraq.

DOI:

https://doi.org/10.56056/amj.2018.32

Keywords:

Bile duct injury, Complications, Laparoscopic, Open Cholecystectomy

Abstract

Background and objectives: Iatrogenic bile duct injury (IBDI) is a serious complication during cholecystectomy caused by a surgeon in apparently healthy patients and is associated with a significant rate of morbidity and a low rate of mortality. Our aim was to review the surgical repair of IBDI and post-operative outcomes regarding morbidity and mortality.

Methods: We retrospectively analyzed the surgical management and outcome of biliary injuries during cholecystectomy in 52 patients diagnosed intraoperatively during cholecystectomy or referred postoperatively to Sulaymaniyah digestive and liver surgery center between May 2014 and May 2017.

Results: During these three years; we managed 52 patients of which 41 patients (78.8%) were females. Forty-seven bile duct injuries happened during laparoscopic cholecystectomy and in 5 patients during open-type surgery. Eight patients were diagnosed intraoperatively the remaining 44 were diagnosed post-operatively. The most common type of injury was Strasbourg type E2 (33 patients, 63.5%). The mean age of patients was 32 years in females and 36 years in males. Roux-en- Y hepati- cojejunostomy was the surgical treatment in 47 patients (90.4%). Post-operative morbidity within three years was 34.6% and mortality was 3.8%. Patients were followed for one month on their regular visit to our center or private clinic post-operatively then followed by their irregular visits once they had complains within the period of our study.

Conclusions: Hepaticojejunostomy was the best surgical procedure for repair of IBDI with less postoperative morbidity and mortality in our study, IBDI type E4 according to Strasberg classification associated with more morbidity and mortality than other types.

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