Retrospective Study of Common Bile Duct Injury after Laparoscopic Cholecystectomy

Abstract

Laparoscopic cholecystectomy is one of commonest laparoscopic surgeries but carries out serious complications, one of them with high morbidity and mortality which is Bile Duct Injury. Biliary leak, biliary peritonitis and obstructive jaundice presents BDI with different management planes from ERCP and stent application up to abdominal exploration and roux-en-y hepatico-jeujenostomy to restore bile system continuity, this fact drove the attention of healthcare institutes to this problem. Is to assess different types of Bile duct injuries (BDI) after laparoscopic cholecystectomy and the outcome of different surgical procedures and recent radiological interventional procedures. This is a retrospective study carried on 50 patients underwent laparoscopic cholecystectomy and complicated by bile duct injury in benha university hospitals, after approval of local ethics committee, all patients included in the study were informed about the procedure and a written consent was obtained from every patient before carrying the different surgical procedures and recent radiological interventions. The study was done from January 2004 till January 2020. BDI during laparoscopic cholecystectomy occur more frequently when compared to open surgery. They occur twice to three times, more frequently than after an open surgery. Among early presentations is bile leak which occurred in (56%) who present early within first week. Different plans of management which differs from radiological intervention with (14%) up to abdominal exploration with (70%). Increased incidence of bile duct injury with laparoscopic cholecystectomy more than open cholecystectomy. Over confidence of some surgeons can cause serious damage. Roux en y Hepatico-jeujonostomy is the preferred surgical procedure. Intervention radiology plays important role in diagnosis and management of BDI.