MANAGEMENT AND OUTCOMES OF IATROGENIC BILE DUCT INJURIES FOLLOWING OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY
Main Article Content
Keywords
Iatrogenic bile duct injury, Roux-en-Y choledochojejunostomy, Cholecystectomy, Postoperative complications
Abstract
Background: Iatrogenic bile duct injury (IBDI) is a rare but dangerous side effect of cholecystectomy, especially as laparoscopic procedures become more widespread. If not identified and treated right away, these injuries might result in serious morbidity. Improving patient outcomes requires knowing how frequently various surgical repair options occur and how effective they are.
Study design: Descriptive study Design
Duration and place of study: This study was conducted in Mekran Medical College Turbat at Kech Balochistan from January 2023 to January 2025
Objective: The present study aims at the determination of the frequency as well as outcomes of the IBDI followed by open and laparoscopic cholecystectomy procedures.
Methods: This case series was descriptive and included 120 patients who presented with IBDI. Laboratory tests, clinical examinations, and selected imaging utilising MRCP and ERCP were used to assess the patients. Surgical procedures included primary repair over a T-tube, choledochoduodenostomy, or Roux-en-Y choledochojejunostomy, depending on the type of lesion. For six months, patients were tracked and postoperative improvement was tracked.
Results: 72 (60%) of the 120 patients were referred from peripheral centres, while 48 (40%) of the patients had injuries locally. Females outnumbered males (M:F = 1:4), and the average age was 40.56 ± 3.66 years. Bile leakage, stomach discomfort, and jaundice were the most frequent presenting symptoms. Choledochoduodenostomy (25%) and primary repair over T-tube (10%) were the next most common procedures, after Roux-en-Y choledochojejunostomy (65%). Among the complications were recurrent cholangitis (5%), wound infection (15%), and bile leak (10%). A typical hospital stay lasted between 10 and 15 days.
Conclusion: Roux-en-Y choledochojejunostomy is a reliable and preferable technique for the management of the IBID with least chances of postoperative complications. Early diagnosis and surgical intervention are crucial for optimal patient outcomes.
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Imam Bakash
Associate Professor of Surgery, Mekran Medical College Turbat at Kech Balochistan Pakistan
Fida Ahmed
Associate Professor of Surgery, Surgical unit 4 Bolan Medical Complex Hospital Quetta Pakistan
Asghar Ali
Senior Registrar of Surgery, Mekran Medical College Turbat at Kech Balochistan Pakistan
Irshad Ahmed
Senior Registrar of Surgery, Jhalawan Medical College Khuzdar Balochistan Pakistan
Saiqa Rafiq
Senior Registrar of Surgery, Mekran Medical College Turbat at Kech Balochistan Pakistan
Nazia Naseer
Assistant Professor of Surgery, Mekran Medical College Turbat at Kech Balochistan Pakistan