Impact of concomitant vascular injury on the outcome of bile duct injury

Abstract

Background Compared with open cholecystectomy, the frequency of iatrogenic bile duct damage (bile duct injury) has almost doubled as laparoscopic cholecystectomy (LC) has become more prevalent. The authors aimed to analyze the prevalence of postcholecystectomy vasculobiliary injury and its influence on illness and death. Methods Medical records were reviewed on 50 consecutive patients with iatrogenic bile duct injuries from either open or laparoscopic cholecystectomy who were treated at the National Liver Institute, Menoufia University between January 1, 2020 and October 31, 2022. The medical records were examined for patient demographics and preoperative and postoperative clinical scenarios, which included symptoms, operative procedures, diagnostic methods, operative repairs, length of ICU and Hospital stays, postoperative follow-up, short- and long-term complications, need for radiographic or operative revision, and patient mortality. Results The studied patients were allocated into two groups, according to presence of concomitant vascular injury; group A: cases did not develop concomitant vascular injury, group B: cases developed concomitant vascular injury. Vascular injury was significantly elevated in males than those without vascular injury (P=0.027). There were no significant variance among the studied groups as regard Hospital stay and ICU admission. There was no significant variance among the studied groups as regard short-term complications. There was a significant variance among the studied groups as regard long-term complications (P=0.003). Right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury. Conclusions Concomitant vascular injury postcholecystectomy prevalence was significantly associated with long-term complications; right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury.