AN OBSERVATIONAL ANALYTICAL STUDY OF VARIED PRESENTATIONS OF IATROGENIC BILE DUCT INJURIES AT A TERTIARY REFERRAL CENTRE

Somdatta Lahiri, Saket Jha, Gautam Ghosh, Shibajyoti Ghosh

Abstract


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.


Keywords


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

References


Boerma D, Rauws EA, Keulemans YC, Bergman JJ, Obertop H, and Huibregtse K, et al. (2001). “Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: A prospective analysis”, Ann Surg, Vol.234, pp.750–757.

Carroll BJ, Birth M, and Phillips EH. (1998). “Common bile duct injuries during laparoscopic cholecystectomy that result in litigation”, Surg. Endosc, Apr, Vol.12(4), pp.310-313.

Fischer CP, Fahy BN, Aloia TA, Bass BL, Gaber AO, and Ghobrial RM. (2008). “Timing of referral impacts surgical outcomes in patients undergoing repair of bile duct injuries”, HPB, pp.32-37, available online: https://core.ac.uk/download/pdf/82721275.pdf

Fletcher DR, Hobbs MS, and Tan P, et al. (1999). “Complications of cholecystectomy: Risks of the laparoscopic approach and protective effects of operative cholangiography: A population based study”, Ann. Surg, Vol.229, p.449.

Gigot J, Etienne J, Aerts R, Wibin E, Dallemagne B, Deweer F, Fortunati D, Legrand M, Vereecken L, Doumont J, Van Reepinghen P, and Beguin C. (1997). “The dramatic reality of biliary injury during laparoscopic cholecystectomy: an anonymous multicentre Belgian survey of 65 patients”, SurgEndosc, Vol.11, pp.1171-1178.

Hall JG, and Pappas TN. (2004). “Current management of biliary strictures”, J Gastrointest Surg, Vol.8, pp.1098-1110.

Kapoor VK. (2016). “Medico-legal aspects of bile duct injury”, J Minim Access Surg, Jan-Mar, Vol.12(1), pp.1-3.

Lubikowski J, Post M, Białek A, Kordowski J, Milkiewicz P, and Wojcicki M. (2011). “Surgical management and outcome of bile duct injuries following cholecystectomy: a single-center experience”, Langenbecks Arch Surg, Vol.396(5), pp.699-707.

McDonald ML, Farnell MB, Nagorney DM, Ilstrup DM, and Kutch JM. (1995). “Benign biliary strictures: repair and outcome with a contemporary approach”, Surgery, Vol.118, pp.582–591.

Melton GB, Lillemoe KD, Cameron JL, Sauter PA, Coleman J, and Yeo CJ. (2002). “Major bile duct injuries associated with laparoscopic cholecystectomy: effect of surgical repair on quality of life”, Ann Surg, Jun, Vol.235(6), pp.888-895.

Strasberg SM, Hertl M, and Soper NJ. (1995). “An analysis of the problem of biliary injury during laparoscopic cholecystectomy”, J Am Coll. Surg, Vol.180, pp.101-125.


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