Bile duct injury following cholecystectomy

Rev Col Bras Cir. 2011 Mar-Apr;38(2):95-9. doi: 10.1590/s0100-69912011000200005.
[Article in English, Portuguese]

Abstract

Objective: To describe the epidemiological, clinical and surgical features of patients with iatrogenic bile duct injury (IBDI) attending the General Hospital of Fortaleza (HGF) during the period from 2005 to 2009.

Methods: We conducted a retrospective study of medical records of patients admitted to HGF with the diagnosis of IBDI, evaluating the following variables: gender, age, origin, conditions of cholecystectomy, type of surgery, symptoms, exams performed, surgical findings, classification of injury, treatment, complications, total duration of hospitalization and discharge conditions.

Results: There were 27 confirmed cases of IBDI. Two injuries occurred during laparoscopic cholecystectomy. Only one patient was diagnosed intraoperatively. The most frequent sign was jaundice after cholecystectomy. Hepato-duodenal Y-en-Roux anastomosis was the most often employed surgical technique (85.2%). Most patients were discharged from hospital in good clinical condition (88.8%), however, we found high morbidity rates for this disease, exemplified by the multiple hospitalizations and longer hospital stay (mean 31 days).

Conclusion: Most injuries occurred during open cholecystectomy, jaundice was the most frequent sign upon admission. There was a high hospitalization length of stay, caused by postoperative complications, which could be explained by delayed diagnosis resulting in a large delay in treatment.

MeSH terms

  • Adult
  • Aged
  • Bile Ducts / injuries*
  • Bile Ducts / surgery*
  • Cholecystectomy*
  • Cohort Studies
  • Female
  • Humans
  • Intraoperative Complications / epidemiology*
  • Intraoperative Complications / etiology
  • Intraoperative Complications / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult