临床病例报告杂志

Incidence of Iatrogenic Bile Duct Injury Following Open and Laparoscopic Cholecystectomy and its Treatment Outcome

Abstract

Imtiaz Ali Soomro, Fahad Ali Mangrio, Mahaveer Singh Bherulal and Munawar Ali Rajper

Objective: To find out the incidence of iatrogenic bile duct injury following open and laparoscopic cholecystectomy and their postoperative outcome.

Material and methods: Twenty patients with iatrogenic bile duct injuries were admitted through the OPD and emergency department of PMC Hospital Nawabshah. Apart from baseline investigations, MRCP and ERCP were performed in selected cases. Postoperatively patients were monitored in the surgical ward and sent home after removing their drains. Patients were followed up in the OPD for 6 months. Data was collected and analyzed on SPSS Version 10.

Results: Out of 20 cases, 8 (40%) sustained injuries in our unit while 12 (60%) were referred from peripheral hospitals. The mean age was 40± 3 years and the male to female ratio was 1:4. Presenting complaints were jaundice, abdominal pain and persistent bile discharge. Procedure performed included Roux en Y (65%), choledochoduodenostomy (25%) and primary repair over T-tube (10%). Post-operative complications were bile leak (10%), wound infection (15%) and recurrent cholangitis (5%). Mortality was zero. The average hospital stay was 10-15 days.

Conclusion: Roux en Y choledochojejunostomy is the preferred surgical procedure for iatrogenic bile duct injuries with minimal postoperative complications.