Managing bile duct injuries sustained during cholecystectomies

Vijay Prakash Srivastava; Shwetank Agarwal; Ajai Agarwal; Jagadamba Sharan

doi:10.18203/2349-2902.isj20175885

Authors

Vijay Prakash Srivastava Department of Surgery, Rajshree Medical and Research Institute, Bareilly, Utter Pradesh, India
Shwetank Agarwal Department of Surgery, Rajshree Medical and Research Institute, Bareilly, Utter Pradesh, India
Ajai Agarwal Department of Surgery, Rajshree Medical and Research Institute, Bareilly, Utter Pradesh, India
Jagadamba Sharan Department of Surgery, Rajshree Medical and Research Institute, Bareilly, Utter Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175885

Keywords:

Bile duct injuries, Bilioma and biliary fistula, Laparoscopy and open cholecystectomy

Abstract

Background: Medical science is a blend of Art and Science. Technology evolved conceived presumably to improve the medical science. Increasing incidence of bile duct injury during laparoscopic cholecystectomies proved otherwise. Multiple factors e.g. cognitive psychology, laparoscopic environment and no proper algorithms to manage, factor may be responsible for these results. To understand properly the mystique, we under took this study.

Methods: This study was conducted on 200 cases which underwent laparoscopic cholecystectomies. 12 cases developed bile duct injury during laparoscopic cholecystectomies and 10 cases of bile duct injury sustained through open cholecystectomies were studied in detail results noted and analyzed.

Results: All these cases 12/200 laparoscopic cholecystectomy, 10/200 open cholecystectomies were followed up, sign and symptoms noted, USG studies, ERCP stenting, sphincterotomy studies reviewed and sequence of management underlined.

Conclusions: Early realisation of bile duct injuries remains the hall mark of she success. Even in cases detected late, conservative procedure and stenting with or without sphincterotomy given relief in number of cases. Finally, if surgery is contemplated Roux-Y-biliary enteric procedure gives much better results.

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