Surgery, Gastroenterology and Oncology
Vol. 25, Nr. 4, Sept 2020
Long-Term Results of Surgical Repair of Bile Duct Injuries Following Laparoscopic Cholecystectomy
Ghofrane Talbi, Wael Ferjaoui, Mohamed Hajri, Houssem eddine Smati, Sahir Omrani, Dhouha Bacha, Rached Bayar, Lasaad Gharbi, Mohamed tahar Khafallah
ORIGINAL PAPER, Sept 2020
Article DOI: 10.21614/sgo-25-4-194
Background: The iatrogenic injury of the bile ducts is a serious accident of laparoscopic cholecystectomy. Its management is multidisciplinary. The aim of our work was to elucidate the factors influencing the long-term results after biliary repair.

Methods: A retrospective, analytical and descriptive study was carried out on a series of 44 cases of biliary injuries repaired over a period of 14 years.

Results: The injury was discovered intraoperatively in 18 cases, in early postoperative period in 20 cases and in late postoperative period in 6 cases. In total, there were 24 lesions classified D, five lesions (E1), five lesions (E2), five lesions (E3), four lesions (E4) and a lesion (E5). Immediate repair was performed on 16 patients: 9 repairs over T-tube, 5 hepatico-jejunal anastomosis, 1 end-to-end biliary anastomosis and one patient had bilioduodenal anastomosis. Early repair was performed on 8 patients: 7 patients had a repair of the common bile duct over T-tube and only 1 patient had an hepatico-jejunal anastomosis.20 patients were repaired late by hepatico-jejunal anastomosis. Hepatic resection has been reported in 4 of our patients. The overall mortality of biliary repairs was 9% and the overall morbidity was 18%. 13 patients presented biliary stricture. The factors influencing long-term outcomes were: Age (p = 0.023), absence of cholangiogram at repair (p = 0.04) and immediate repairs (p = 0.048). Late repair was associated with good long-term results.

Conclusion: The iatrogenic wound of the bile ducts is a frightening accident of laparoscopic cholecystectomy. Its care is multidisciplinary but not yet consensual.

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Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)



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