Bile duct injuries after cholecystectomy, analysis of constant risk

Ann Hepatobiliary Pancreat Surg. 2020 May 31;24(2):150-155. doi: 10.14701/ahbps.2020.24.2.150.

Abstract

Backgrounds/aims: The bile duct injuries are the most severe complications that occur after the surgical manipulation of the bile duct. The hepaticojejunostomy remained as the best treatment. Several factors identified that affect the result. This study aimed to analyze and identify risk factors that affected the evolution of these patients.

Methods: A retrospective, observational study was conducted from February 1998 to June 2017. We included all patients with bile duct injuries who required surgical treatment.

Results: We found 79 patients. The majority had a Bismuth type III in 35.4% (n=28). The morbidity of the Hepaticojejunostomy was 19% (n=15). In short-term follow-up, the main complications were cholangitis 11.4% (n=9) and bile leak 10% (n=8). In the long-term follow-up, in 2.5% (n=2) stricture was presented. On the comparison between postoperative and preoperative parameters, biliary peritonitis after a cholecystectomy (p=0.02) was an independent predictor of postoperative morbidity (p<0.05).

Conclusions: In the treatment of bile duct injuries, different factors affect their outcomes. Our results show that infectious complications continue to affect the results of the treatment of bile duct lesions.

Keywords: Bile duct; Cholecystectomy; Gallbladder; Iatrogenic injuries.