IATROGENIC BILE DUCT INJURIES REQUIRING SURGICAL RECONSTRUCTION - PRESENTATION AND CLASSIFICATION OF THE LESIONS, THEIR RECONSTRUCTION AND OUTCOMES

Lokesh Arora, Musunuru Brahmeswara Rao, Vutukuru Venkatarami Reddy, Chandrakasan Chandramaliteswaran

Abstract


INTRODUCTION:  Iatrogenic bile duct injury during cholecystectomy is associated with high morbidity and is a potentially life-threatening complication. The aim of the study was to assess the outcomes following.

METHODS: All patients who presented with bile duct injury following both open and lap cholecystectomy from January 2013 to April 2018 were included. Excluded patients treated with endoscopic stenting alone.

RESULTS: 20 patients were included in the study. Roux en Y hepaticojejunostomy was done in 18 patients. On follow up, 1 patient with Type III stricture developed anastomotic stricture which was managed with Transhepatic stricture dilation. Outcome was graded into grade A in 14 (77.78%) patients, grade B in 2 (11.11%) patient and grade D in 1(5.56%) patient. Mortality in one (5.56%) patient following hepaticojejunostomy due to renal failure.

CONCLUSION: Management of post cholecystectomy biliary injuries is based on presentation. Most of these require Hepaticojejustomy. Outcomes following hepaticojejunostomy are good but require longterm surveillance.


Keywords


Bile duct injury, Post cholecystectomy, Hepaticojejunostomy

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References


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