Euroasian Journal of Hepato-Gastroenterology

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VOLUME 10 , ISSUE 1 ( January-June, 2020 ) > List of Articles

Original Article

Management of Bile Duct Injuries: A 6-year Experience in a High Volume Referral Center

Simay Dal Çavuşoğlu, Mutlu Doğanay, Birkan Birben, Gökhan Akkurt, Özgur Akgul, Mehmet Keşkek

Keywords : Bile duct, Cholecystectomy, Endoscopy

Citation Information : Çavuşoğlu SD, Doğanay M, Birben B, Akkurt G, Akgul Ö, Keşkek M. Management of Bile Duct Injuries: A 6-year Experience in a High Volume Referral Center. Euroasian J Hepatogastroenterol 2020; 10 (1):22-26.

DOI: 10.5005/jp-journals-10018-1309

License: CC BY-NC 4.0

Published Online: 01-06-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objectives: The aim of our study was to determine operative and nonoperative treatments performed in bile duct injuries and the effect of a multidisciplinary approach on the treatment. Background: Bile duct injuries may lead to morbidities such as biliary leakage, peritonitis, and mortality. Materials and methods: A total of 83 patients with biliary complications (37 patients with iatrogenic bile duct injury referred to our clinic from other centers were also included in this study) were evaluated. Results: Of the operated 6,663 patients, iatrogenic bile duct injury occurred in 46 (0.69%) of these patients. The most common type of injury was Strasberg type A injury, which was found in 48 (57.83%) patients. The time interval between the diagnosis and initiation of treatment after the operation was shorter in patients with an inserted cavity drainage catheter (p < 0.05). Of the patients with bile duct injury, 32.6% received surgical and 62.6% endoscopic treatment, while 4.8% were followed-up without intervention. The rate of mortality was found to be 2.4%. Conclusion: Time interval to diagnosis is of great importance for management of the patients.


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  1. Al-Kubati WR. Bile duct injuries following laparoscopic cholecystectomy: a clinical study. Saudi J Gastroenterol 2010;16(2):100. DOI: 10.4103/1319-3767.61236.
  2. Karanikas M, Bozali F, Vamvakerou V, et al. Biliary tract injuries after lap cholecystectomy—types, surgical intervention and timing. Ann Transl Med 2016;4(9):163. DOI: 10.21037/atm.2016.05.07.
  3. Duca S, Bãlã O, Al‐Hajjar N, et al. Laparoscopic cholecystectomy: incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations. HPB Surg 2003;5(3):152–158. DOI: 10.1080/13651820310015293.
  4. Machado NO. Biliary complications post laparoscopic cholecystectomy: mechanism, preventive measures, and approach to management: a review. Diagn Ther Endosc 2011;2011:967017. DOI: 10.1155/2011/967017.
  5. Salama IA, Shoreem HA, Saleh SM, et al. Iatrogenic biliary injuries: multidisciplinary management in a major tertiary referral center. HPB Surg 2014;2014::575136. DOI: 10.1155/2014/575136.
  6. Abbasoglu O, Tekant Y, Alper A, et al. Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: expert consensus statement. Ulus Cerrahi Derg 2016;32(4):300–305. DOI: 10.5152/UCD.2016.3683.
  7. Strasberg SM. Laparoscopic biliary injuries. diseases of the gallbladder and bile ducts: diagnosis and treatment. HPB Surg 2008. 182.
  8. Brunicardi F, Andersen D, Billiar T, et al. Schwartz's Principles of Surgery. New York: McGraw-Hill Professional; 2004.
  9. Basara BB, Guler C, Yentur G, The Ministry of Health of Turkey health statistics yearbook 2012. General Directorate of Health Research, Republic of Turkey Ministry of Health 2013.
  10. Rauws E, Gouma D. Endoscopic and surgical management of bile duct injury after laparoscopic cholecystectomy. Best Practice & Research 2004;18(5):829–846. DOI: 10.1016/j.bpg.2004.05.003.
  11. Jarnagin WR, Blumgart L. Blumgart's surgery of the liver, biliary tract, and pancreas. Elsevier Saunders; 2012.
  12. Csendes A, Navarrete C, Burdiles P, et al. Treatment of common bile duct injuries during laparoscopic cholecystectomy: endoscopic and surgical management. World J Surg 2001;25(10):1346–1351. DOI: 10.1007/s00268-001-0121-5.
  13. Massarweh NN, Devlin A, Symons RG, et al. Risk tolerance and bile duct injury: surgeon characteristics, risk-taking preference, and common bile duct injuries. J Am Coll Surg 2009;209(1):17–24. DOI: 10.1016/j.jamcollsurg.2009.02.063.
  14. Pucher PH, Brunt LM, Fanelli RD, et al. SAGES expert Delphi consensus: critical factors for safe surgical practice in laparoscopic cholecystectomy. Surg Endosc 2015;29(11):3074–3085. DOI: 10.1007/s00464-015-4079-z.
  15. Sicklick JK, Camp MS, Lillemoe KD, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg 2005;241(5):786. DOI: 10.1097/01.sla.0000161029.27410.71.
  16. Stewart L. Iatrogenic biliary injuries: identification, classification, and management. Surgical Clinics 2014;94(2):297–310. DOI: 10.1016/j.suc.2014.01.008.
  17. Kapoor VK. Management of bile duct injuries: a practical approach. Am Surg 2009;75(12):1157–1160.
  18. De Reuver PR, Busch ORC, Rauws EA, et al. Long-term results of a primary end-to-end anastomosis in peroperative detected bile duct injury. J Gastrointest Surg 2007;11(3):296–302. DOI: 10.1007/s11605-007-0087-1.
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