Research Article
Volume 10 Issue 1 - 2021
Post Cholecystectomy CBD Injury Repaired Early- A Study
Purujit Choudhury*
Professor of Surgery, Gauhati Medical College, India
*Corresponding Author: Purujit Choudhury, Professor of Surgery, Gauhati Medical College, India.
Received: May 01, 2020; Published: December 31, 2020




Abstract

Postcholecystectomy bile duct injuries are the causes of significant morbidity and occasional mortality. Intra-operative recognition and repair of complete biliary transaction with hepaticojejunostomy is the recommended treatment; however, it is possible only in few patients as either the injury is not recognized intraoperatively or the center is not geared up to perform an urgent hepaticojejunostomy in these patients with a nondilated duct. Retrospective analysis of data from our tertiary care referral center over a period of 10 years from January 2010 to December 2019 to report the feasibility and outcomes of prompt repair was done (defined as repair within 72h of index operation) of postcholecystectomy bile duct injury. Ten patients of postcholecystectomy bile duct injury detected intra operatively and referred early underwent prompt repair. All patients had a complete transaction of the bile duct (type of injuries as per Strasberg classification: Type EV: 1, Type E III: 7, Type E II: 3 and Type E1: 1). The mean duration between injury and bile duct repair in the form of Roux-en-Y hepaticojejunostomy (RYHJ) was 22.7 (range 5 - 42) hours. The mean stomal diameter of the anastomosis was 1.63 (range 1 - 2.1) cm, and the anastomosis was stented in 7 patients. The mean duration of surgery was 4.6 + 1.7h. One patient developed bile leak on the first postoperative day, which were settled by day 5. The mean duration of hospital stay was 8 (range 8 - 12) days. With a mean follow-up of 42 (range 24 - 110) months, all patient had excellent (70%) or good outcome (30%). Prompt RYHJ (within first 72h) for postcholecystectomy biliary transaction is an effective treatment and potentially limits the morbidity to the patient.

Keywords: Bile Duct Injury (BDI); Roux-en-Y Hepaticojejunostomy (RYHJ); Cholecystectomy; Biliary Transaction; CBD (Common Bile Duct)

References

  1. Ria D and Olsen D. “Bile duct injuries during laparoscopic cholecystectomy”. Surgical Endoscopy 2 (1997): 133-138.
  2. Phillips EH., et al. “Common bile duct injuries during laparoscopic cholecystectomy that result in litigation”. Surgical Endoscopy 4 (1998): 310-314.
  3. Blumgarh LH., et al. “Operative repair of bile duct injuries involving the hepatic duct confluence”. Archives of Surgery 134 (1999): 769.
  4. Mercado MA. “Early versus late repair of bile duct injuries”. Surgical Endoscopy 20 (2006): 1644-1647.
  5. Strasberg SM., et al. “An analysis of the problem of biliary injury during laparoscopic cholecystectomy”. Journal of the American College of Surgeons 180 (1995): 101-125.
  6. Mc Donald MI., et al. “Benign biliary strictures: repair and outcome with a contemporary approach”. Surgery 118 (1995): 582-591.
  7. Calvete J., et al. “Bile duct injury during laparoscopic cholecystectomy: myth or reality of the leaning curve?” Surgical Endoscopy 14 (2000): 608-611.
  8. Flum DR., et al. “Bile duct injury during cholecystectomy and survival in medicare beneficiaries”. The Journal of the American Medical Association 290 (2003): 2168-2173.
  9. Bergaman JJ., et al. “Treatment of bile duct lesions after laparoscopic cholecystectomy”. Gut1 (1996): 141-147.
  10. Walsh RM., et al. “Long-term outcome of biliary reconstruction for bile duct injuries from laparoscopic cholecystectomies”. Surgery 4 (2007): 465-457.
  11. Goykhman Y., et al. “Long-term outcome and risk factors of failure after bile duct injury repair”. The Journal of Gastrointestinal Surgery 8 (2008): 1412-1417.
  12. Sahajpal AK., et al. “Bile duct injuries associated with laparoscopic cholecystectomy. Timing of repair and long-term outcomes”. Archives of Surgery 8 (2010): 757-763.
  13. Mercado MA., et al. “A cute bile duct injury. The need for a high repair”. Surgical Endoscopy 9 (2003): 1351-1355.
  14. Lau WY., et al. “Management of bile duct injury after laparoscopic cholecystectomy: a review”. ANZ Journal of Surgery 80 (2010): 75-81.
  15. Gupta N., et al. “Management and outcome of patients with combined bile duct and hepatic artery injuries”. Archives of Surgery 133 (1998): 176-181.
  16. Chapman WC., et al. “Postcholecystectomy bile duct strictures: management and outcome in 130 patients”. Archives of Surgery 130 (1995): 597-604.
  17. Sikora SS., et al. “Postcholecystectomy benign biliary strictures long-term results”. Digestive Surgery 5-6 (2006): 304-312.
  18. Murr MM., et al. “Long term results of biliary reconstruction after laparoscopic bile duct injuries”. Archives of Surgery 6 (1999): 604-610.
Citation: Purujit Choudhury. “Post Cholecystectomy CBD Injury Repaired Early- A Study”. EC Paediatrics 10.1 (2021): 127-132.

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