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Early Surgical Repair of Bile Duct Injuries following Laparoscopic Cholecystectomy: The Sooner the Better. | LitMetric

AI Article Synopsis

  • The study focused on the outcomes of immediate surgical repair for bile duct injuries (BDIs) that occur after laparoscopic cholecystectomy, involving 13 patients treated within 72 hours of diagnosis.
  • The injuries were classified by type; most were severe (type E and D), and various surgical procedures were used based on the type of injury.
  • Results showed a mean hospital stay of 6.6 days, a 30% morbidity rate, and no reported deaths, suggesting that early surgical intervention can lead to favorable outcomes in these patients.

Article Abstract

 We aimed to investigate the outcomes of the immediate surgical repair of bile duct injuries (BDIs) following laparoscopic cholecystectomy.  Between January 2012 and May 2017, patients, who underwent immediate surgical repair (within 72 hours) for postcholecystectomy BDI, by the same surgical team expert in hepatobiliary surgery, were enrolled into the study. Data collection included demographics, type of BDI according to the Strasberg classification, time to diagnosis, surgical procedures, and outcome.  There were 13 patients with a mean age of 43 ± 12 years. Classification of BDIs were as follows: type E in six patients (46%), type D in three patients (23%), type C in two (15%), and types B and A in one patient each (7.6%). Mean time to diagnosis was 22 ± 15 hours. Surgical procedures included Roux-en-Y hepaticojejunostomy for all six patients with type-E injury, primary repair of common bile duct for three patients with type-D injury, and primary suturing of the fistula orifice was performed in two cases with type-C injury. Other two patients with type-B and -A injury underwent removal of clips which were placed on common bile duct during index operation and replacing of clips on cystic duct where stump bile leakage was observed probably due to dislodging of clips, respectively. Mean hospital stay was 6.6 ± 3 days. Morbidity with a rate of 30% (  = 4) was observed during a median follow-up period of 35 months (range: 6-56 months). Mortality was nil.  Immediate surgical repair of postcholecystectomy BDIs in selected patients leads to promising outcome.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800276PMC
http://dx.doi.org/10.1055/s-0039-1697633DOI Listing

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