Repair 0ptions Following Iatrogenic Bile Duct Injuries
Journal of Surgery
Volume 3, Issue 5, October 2015, Pages: 50-55
Received: Oct. 1, 2015; Accepted: Oct. 13, 2015; Published: Oct. 24, 2015
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Authors
Mohamed Salah Eldin Abdelhamid, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Ahmed Mohamed Sadat, Surgery Department, Kasr Elaini Faculty of Medicine, Cairo University, Cairo, Egypt
Ayman Hamdi Abouleid, Surgery Department, October 6th Faculty of Medicine, October 6th University, Giza, Egypt
Amr Mohamed Aly Mohamed, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Mahmoud Ahmed Negida, Surgery Department, Kasr Elaini Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Zaki Gharib, Surgery Department, October 6th Faculty of Medicine, October 6th University, Giza, Egypt
Adel Morad Abdullah, Surgery Department, October 6th Faculty of Medicine, October 6th University, Giza, Egypt
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Abstract
In the era of laparoscopic cholecystectomy there was a dramatic increase in the incidence of the bile duct injuries. It was estimated that major bile duct injury occurred in approximately 0.2% to 0.4% during open cholecystectomy opposed to 0.6% to 0.8% of patients undergoing laparoscopic cholecystectomy. The aim was to highlight the repair options for the happened injury. Included in the study were 22 patients, 19 sustained injury at our hospital and 3 referral cases between Feb. 1999 to Nov2014. The treatment options were end to end anastomosis over T-tube or straight stent and Roux-en Y hepaticojejunostomy with or without stenting the anastomosis. Regarding the injuries, according to Strasberg there were 2 A, 4 D, 8 E1, and 5 E2. The three referral cases were choledochodoudonostomy. They were treated through simple ligation of cystic duct in two cases, end to end anastomosis in seven cases (three of them over T-tube and four over straight stent). The remaining fifteen cases were treated with Roux-en Y hepaticojejunostomy with or without stenting the anastomosis (22 patients with 24 interventions due to 2 redo). We concluded that proximal bile ducts are at greater risk with laparoscopic cholecystectomy even with expert surgeon. Satisfactory results were obtained with end to end anastomosis over either T-tube or straight stent, however these two options cannot be applied to all cases as it is difficult to be done with non dilated ducts, so Roux-en-Y hepaticojejunostomy is the most feasible among all types of repairs as it can be applied to most cases even those with non dilated common bile duct.
Keywords
Cholecystectomy, Laparoscopic, Bile Duct, Injuries
To cite this article
Mohamed Salah Eldin Abdelhamid, Ahmed Mohamed Sadat, Ayman Hamdi Abouleid, Amr Mohamed Aly Mohamed, Mahmoud Ahmed Negida, Ahmed Zaki Gharib, Adel Morad Abdullah, Repair 0ptions Following Iatrogenic Bile Duct Injuries, Journal of Surgery. Vol. 3, No. 5, 2015, pp. 50-55. doi: 10.11648/j.js.20150305.12
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Copyright © 2015 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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