Diagnosis and Treatment of Post-Cholecystectomy Iatrogenic Biliary Injury a Retrospective study

Abstract

The management of patients following major bile duct injury is a surgical challenge often requiring the skills of experienced hepatobiliary surgeons at tertiary referral centers. Collaboration among surgeons, gastroenterologists and interventional radiologists is imperative in the care of such injuries. Still, bile duct injuries are reported to be more severe and more common when compared to open cholecystectomy with a reported incidence of up to 0.6% for laparoscopic versus 0.1% for open cholecystectomy. These injuries are a disaster for both the patient and the surgeon because of the associated morbidity, prolonged hospitalization, and mortality. The majority of iatrogenic bile duct injuries occur during cholecystectomy with or without common bile duct exploration. The introduction of laparoscopic cholecystectomy in surgical practice resulted in an increased incidence of bile duct injuries and required new classification systems. Injury occurs as a result of technical errors or misidentification of ducts. Inexperience, inflammation, and aberrant anatomy are key risk factors.