Surgical Management of Complex Bile Duct Injuries in Specialized Hepatopancreatobiliary (HPB) Unit

Abstract

Objective: To describe the surgical management of complex bile duct injuries in a specialized hepatopancreatobiliary unit. Design of the Study: It was a retrospective study. Study Settings: This study was carried out at Department of Anaesthesia and Hepatobiliary Unit, Sheikh Zayed Hospital Lahore from August 2017 to August 2019. Material and Methods: This retrospective study includes 80 patients of bile duct injury who underwent surgical correction of bile duct injury at specialized Hepatopancreatobiliary [HPB] and liver transplant department of Shaikh Zayed Hospital Lahore. All the subjects were evaluated by retrospectively. The information regarding primary operative procedure, drain placement, T-tube placement, presentation, hospital stay, Liver Function Tests [LFTs], level of biliary tract injury and type of surgical procedure obtained from patients records. Results of the Study: During the study period 80 patients – 65 females and 15 male were operated for bile duct injury. Mean age was 39.89 years range 21 to 65 years. Hospital stay ranges from 9 to 36 days with mean of 16.18 days. Patients underwent open cholecystectomy, 43.8% laparoscopic cholecystectomy and in 3 patients procedure was converted from laparoscopic to open. 52.5% patients underwent open cholecystectomy, 43.8 laparoscopic cholecystectomy and in 3 patient’s procedure was converted from laparoscopic to open. Conclusion: It is concluded that the correct long lasting and physiological method to treat injuries of bile duct is only surgical repair. Although, surgical repair of bile duct must be operated by skilled hepatopancreaticobiliary surgeons. A practical method which is selected appropriately and implemented successfully has surely improved surgical outcome without any problem faced during the operation. Keywords: Hepatopancreatobiliary, Bile Duct Injury, Surgical Management