Analysis of the risk factors, acute presentation, management and outcome associated with post cholecystectomy bile duct injury

Rambit C. Dwivedi; Neelam Kumari; Krishna K. Singh; Dhirendra P. Singh; Arshad Ahmad; Sandeep Verma; Suresh Kumar; Upander Kumar; Sanjeev Kumar; Aneeta Singh; Saumya Singh; Ayushi Raj; Vikash Yadaw; Nasir Ansari; Naresh Kumar

doi:10.18203/2349-2902.isj20250137

Authors

Rambit C. Dwivedi Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Neelam Kumari Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Krishna K. Singh Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Dhirendra P. Singh Department of General Surgery, K. K. Hospital, Lucknow, Uttar Pradesh, India
Arshad Ahmad Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Sandeep Verma Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Suresh Kumar Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Upander Kumar Department of Endocrine Surgery, KGMU, Lucknow, Uttar Pradesh, India
Sanjeev Kumar Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Aneeta Singh Department of Trauma Surgery, KGMU, Lucknow, Uttar Pradesh, India
Saumya Singh Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Ayushi Raj Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Vikash Yadaw Department of Trauma Surgery, KGMU, Lucknow, Uttar Pradesh, India
Nasir Ansari Department of General Surgery, KGMU, Lucknow, Uttar Pradesh, India
Naresh Kumar Department of General Surgery, K. K. Hospital, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250137

Keywords:

Cholecystectomy, Bile duct injury, Gallstone

Abstract

Background: Cholecystectomy is one of the most common surgeries in the world. However, its complication has dangerous effects on the patient's health and economic status. It also increases the patient's morbidity and mortality. Objective was to investigate the risk factors, acute presentation, treatment, and outcome of bile duct injury after cholecystectomy.

Methods: This prospective observational study included a total of 70 patients aged 18 years who underwent surgery for benign gallbladder disease. Malignancies of the gallbladder system, injury to the bile duct due to trauma, age >18 years or >70 years were excluded from the study. Various risk factors were queried preoperatively, intraoperatively, and postoperatively from patients and surgeons, and a conclusion was drawn.

Results: Most patients were in the age group 31-50, namely 45 (64.28%). Of the total 70 patients, 20 (28.58%) were male and 50 (71.42%) were female. Total 06 (75%) patients have severe adhesion and 02 (25%) patients have mild adhesion. Of the total 70 patients, only 08 patients have the CALOTS triangle. Total 06 (8.57%) patients had no drainage and 64 (91.42%) patients had drainage. Total 52 (74.28%) most patients had pigtail drainage and 02 (2.85%) least patients had portal vein repair. Most patients were discharged after 54 (71.42%), 09 (12.85%) after discharge on patient request (DOPR), and the fewest patients, 02 (2.85%), were not discharged.

Conclusions: In most cases, bile duct injury occurs after surgery for uncomplicated gallstone disease. Bile duct injury is associated with a variety of surgical complications and can be fatal. Bile duct injury is more common in women because gallstone disease is more common in women.

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