Iatrogenic biliary injuries: a multi institutional experience

Abstract

Objective: To review incidence of iatrogenic biliary injuries on three different HPB referral centre. Methods: A total of 14 patients were included in 24 months in this retrospective cohort study. The patients enrolled on this study are from three HPB referral centre. Demographic, surgical findings and surgical reconstruction were analysed. Results: This HPB referral centres are performing 600–800 laparoscopic cholecystectomy per year. Three patients were from San Ignacio Hospital, two patients from Policy Hospital and 9 patients were from Mederi Hospital in 24 months. The median age was 52 years old. The majority of patients were women. Lesions were classified Strasberg E1 (7) 50%, Strasberg E2 (1) 7.14% Strasberg E4 (3) 21.48% Strasberg E5 (1) 7.14% Strasberg D (2) 14.28%. All patients were reconstructed in the first 2 weeks after the iatrogenic lesions with a Roux en Y Hepatojejunostomy. Early medical complications were one patient with acute myocardial infarction. One 85 years-old patient had a PE two weeks after surgery. No stent or drains were used. No fistulas were reported. Conclusion: Biliary iatrogenic injuries still are frequent. Roux en Y hepaticojejunostomy is a safe technique with low rate fistula or any other surgical complications. Drains or stent are not recommended. HPB centre are attending more patients with iatrogenic biliary injuries.