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 Chandramaliteeswaran

Volume : IX, Issue : II, February - 2020

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 Chandramaliteeswaran

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.