Surgical Management of Post Cholecystectomy Biliary Injuries: A Center Experience.

Mansy, Wael Salah Eldin; Abdelghani, Amr Ahmed Fouad Mohammed; El Hendawey, Sayed; Morsi, Morsi Mohamed

doi:10.21608/zumj.2021.61046.2119

Surgical Management of Post Cholecystectomy Biliary Injuries: A Center Experience.

Document Type : Original Article

Authors

¹ General surgery department zagazig university

² General Surgery Department- Faculty of Medicine- Zagazig University- Egypt

³ General Surgery Department, Faculty of Medicine, Zagazig University

⁴ Department of surgery, Zagazig University

10.21608/zumj.2021.61046.2119

Abstract

Abstract: Introduction: Bile duct injury (BDI) is the nightmare sequalae following gallbladder surgery. Ranging from 0.3 to 1.5%. Patients and methods: A retrospective study done from October 2010 till October 2020; including 162 patients suffered from biliary complications post open and laparoscopic cholecystectomy. All the patients were managed surgically and followed up for at least 2 years in advanced hepato-pancreatico-biliary center, Zagazig University, Egypt. Results: Most of our patients were female (69.75%) with median age (33±12.3) years. Biliary leakage presented in in 71 (43.83%) patients, ligated CHD presented in 59 (36.42%) patients. And long-term biliary stricture was in 29 (17.9%) patients and haemobilia in three patients. Roux-en-Y hepatico-jejunostomy (H-J) was the procedure in all patients. No mortality in our patients while Post-operative complications were detected in 31 (19.13%) patients. post-operative H-J stricture was 13/162 (8.02%) patients. Percutaneous Transhepatic Biliary Drainage (PTBD) used successfully in managing anastomotic stricture in 11 patients. Conclusion: Iatrogenic BDIs represent a catastrophic sequalae post cholecystectomy. Proper management requires, early diagnosis, management of intra-abdominal fluid collection and infection, nutritional support, multi-disciplinary team and expert hepato-biliary surgeon.

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