Surgical Management of Post Cholecystectomy Bile Duct Injuries

AbstractBackground: Due to the complex nature and diversity of bile duct injurie (BDI) controversy exists regarding the best management plan of BDIs and sometimes this problem may be dificult to be managed even in the hands of an experience surgeon. The goal of our study is to evaluate the various techniques used for the management of bile duct injuries in our setup (HAYAT ABAD MEDICAL COMPLEX, KPK, PAKISTAN). Material and Methods: A total of 25 patients were included in this single centered prospective cohort study for the evaluation of various techniques used in our setup (HAYAT ABAD MEDICAL COMPLEX, KPK, PAKISTAN) for appropriate management of BDIs, over a period of 5 years from January 2016 to December 2020. Results: A total of 25 patients were included in this study out of which 7(28%) were male and 18 (72%) were female. Age range was 15-70 years with a mean age of (42 year). CBD injury occurred in 17(68%) patients after open and 8(32%) after laparoscopic cholecystectomy. Majority of the patients presented with obstructive jaundice (76%) and bile leak (16%) other presentation (biliary peritonitis, biloma, cholangitis etc were 8%). Out of 25 most patients 14(56%) had type E injuries and underwent Roux-en-y hepaticojejunostomy. No patient presented with major bile leak or disruption of anastomosis, minor leak occurred in 4 (16%), wound infection in 6(24%), bleeding in 1 (4%), pulmonary embolism in I (4%). Conclusion: For BDIs related biliary strictures adequate biliary reconstruction and Roux-en-y hepaticojejunostomy can produce satisfactory results depending on Strasberg classification and bile duct status. Key Words: Reconstruction, Roux-En-Y Hepaticojejunostomy, Bile Duct Injuries, Biliary Stricture.