Somdatta Lahiri, Saket Jha, Gautam Ghosh, Shibajyoti Ghosh


Background: The effect of delays in referral and pre-referral interventions on the outcome of definitive management of bile duct injury (BDI) has not been widely studied.


Objective: We looked into the association between pre-referral delays and interventions on the outcome of definitive management of BDI.


Methodology: 35 referred patients of post cholecystectomy were prospectively observed for minimum two years follow up after definitive management. Data was analyzed to look for association of outcome with time to referral and pre-referral interventions.


Results: The mean age (mean ± s.d.) of the patients was 44.48±14.20 years. The mean (mean± s.d.) time of identification of BDI was 35.40±86.09 days. Twenty cases (57.14%) were referred to our hospital more than 4 weeks after BDI. Ten cases (28.6%) presented within 2 weeks of injury and the remaining between 2 to 4 weeks. Thirteen patients (37.1 %) had pre-referral interventions. 


Discussion: A trend towards less favourable outcome in cases with more complex injuries and those cases who had inappropriate pre-referral interventions. However, the results were not statistically significant as the sample size was small.


Cholecystectomy, Bile duct injury, Tertiary care, BDI, Iatrogenic bile duct injuries.


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