全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Pattern of Presentation of Iatrogenic Biliary Injury Following Laparoscopic Cholecystectomy

DOI: 10.4236/ojcd.2022.124006, PP. 55-62

Keywords: Bile Duct Injury, Laparoscopic Cholecystectomy, Post-Operative Complications, Bangladesh

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Cholecystectomy is one of the most now common abdominal surgeries performed every day. The incidence of bile duct injury (BDI) following open cholecystectomy is only 0.1% - 0.2%. After the introduction of laparoscopic cholecystectomy, the incidence has gone up to 0.4% - 0.7%. The present study is a prospective analysis of all patients with bile duct injury who were admitted to Dhaka Medical College Hospital during or at a variable period following cholecystectomy. Methods: To determine the pattern of presentation of iatrogenic biliary injury following cholecystectomy in the department of surgery of Dhaka Medical College Hospital, a total of 30 patients were purposively selected from May 2018 to November 2018. Patient particulars, records of physical and clinical evaluation, and operative details were collected by individual researchers. Data analysis was done by SPSS for windows version 21. Results: BDI was found very common among the age group 21 - 30 yrs (36%) and female dominant (60%). Majority of the patients presented with abdominal pain (96%), intra-abdominal collection (88%), biliary peritonitis (68%), cholangitis (60%), and obstructive jaundice (40%), and biliary fistula (40%). Laparoscopic cholecystectomy (84%) was the principal cause of biliary injury in our study. 48% of patients experienced clinical features within 7 days post-cholecystectomy. Per-operative diagnosis was done in only 12% of cases. 44% of patients in this study were recognized as Bismuth grade-3, followed by 36%, grade-2 patients. Management outcomes included wound infection (41.66%), minor bile leak (25%), peritonitis (8.33%), and renal impairment (8.33%). Conclusion: The effect of BDI is an extremely distressful clinical condition for the patients and their family members, hence proper care and management protocol should be followed.

References

[1]  Flum, D.R., Cheadle, A., Prela, C., Dellinger, E.P. and Chan, L. (2003) Bile Duct Injuries during Cholecystectomy and Survival in Medicare Beneficiaries. Journal of the American Medical Association, 290, 2168-2173.
https://doi.org/10.1001/jama.290.16.2168
[2]  Jarnagin, W.R. and Blumgart, L.H. (2000) Benign Biliary Strictures. In: Blumgert, L.H. and Fong, Y.W.B., Eds., Surgery of the Liver and Biliary Tract, 3rd Edition, Saunders Company, Edinburgh.
[3]  Targarona, E.M., Marco, C., Balague, C., et al. (1998) How, When, and Why Bile Duct Injury Occurs: A Comparison between Open and Laparoscopic Cholecystectomy. Surgical Endoscopy, 12, 322-326.
https://doi.org/10.1007/s004649900662
[4]  MacFadyen, B.V., Vecchio, R., Ricardo, A.E. and Mathis, C.R. (1998) Bile Duct Injury after Laparoscopic Cholecystectomy: The United States Experience. Surgical Endoscopy, 12, 315-321.
https://doi.org/10.1007/s004649900661
[5]  Roslyn, J.J., Binns, G.S. and Hughes, E.F. (1993) Open Cholecystectomy: A Contemporary Analysis of 42,474 Patients. Annals of Surgery, 218, 129-137.
https://doi.org/10.1097/00000658-199308000-00003
[6]  Raute, M., Podlech, P. and Jaschke, W. (1993) Management of Bile Duct Injuries and Strictures Following Cholecystectomy. World Journal of Surgery, 17, 553-562.
https://doi.org/10.1007/BF01655124
[7]  Fletcher, D.R., Hobbs, M.S. and Tan, P. (1999) Complications of Cholecystectomy: Risks of the Laparoscopic Approach and Protective Effects of Operative Cholangiography: A Population-Based Study. Annals of Surgery, 229, 449-457.
https://doi.org/10.1097/00000658-199904000-00001
[8]  Morgenstern, L., McGrath, M.F. and Carroll, B.J. (1995) Continuing Hazards of the Learning Curve in Laparoscopic Cholecystectomy. The American Surgeon, 61, 914-918.
[9]  Way, L.W., Stewart, L. and Gantert, W. (2003) Causes and Prevention of Laparoscopic Bile Duct Injuries: Analysis of 252 Cases from a Human Factors and Cognitive Psychology Perspective. Annals of Surgery, 237, 460-469.
https://doi.org/10.1097/01.SLA.0000060680.92690.E9
[10]  Saddique, M., Rajput, A. and Ahmed, M. (2012) Bile Duct Injury: Management and Outcome. Journal of Surgery Pakistan (International), 17, 156-159.
[11]  Branum, G., Schmitt, C. and Baillie, J. (1993) Management of Major Biliary Complications after Laparoscopic Cholecystectomy. Annals of Surgery, 217, 532-540.
https://doi.org/10.1097/00000658-199305010-00014
[12]  Boerma, D., Rauws, E.A., Keulemans, Y.C., Bergman, J.J., Obertop, H., Huibregtse, K. and Gouma, D.J. (2001) Impaired Quality of Life 5 Years after Bile Duct Injury during Laparoscopic Cholecystectomy: A Prospective Analysis. Annals of Surgery, 234, 750-757.
https://doi.org/10.1097/00000658-200112000-00006
[13]  Moore, D.E., Feurer, I.D., Holzman, M.D., Wudel, L.J., Strickland, C., Gorden, D.L., Chari, R., Wright, J.K. and Pinson, C.W. (2004) Long-Term Detrimental Effect of Bile Duct Injury on Health-Related Quality of Life. The Archives of Surgery, 139, 476-482.
https://doi.org/10.1001/archsurg.139.5.476
[14]  Mirza, D.F., Rossi, R.L., Lowell, J.A. and Munson, J.L. (1997) Bile Duct Injury Following Laparoscopic Cholecystectomy: Referral Pattern and Management. British Journal of Surgery, 84, 786-790.
https://doi.org/10.1046/j.1365-2168.1997.02666.x
[15]  Slater, K., Strong, R.W., Wall, D.R. and Lynch, S.V. (2002) Iatrogenic Bile Duct Injury: The Scourge of Laparoscopic Cholecystectomy. ANZ Journal of Surgery, 72, 83-88.
https://doi.org/10.1046/j.1445-2197.2002.02315.x
[16]  Bismuth, H. (1982) Postoperative Strictures of the Bile Ducts. In: Blumgart, L.H., Ed., The Biliary Tract V, Churchill-Livingstone, New York, 209-218.
[17]  Schol, F.P., Go, P.M. and Gouma, D.J. (1995) Outcome of 49 Repairs of Bile Duct Injuries after Laparoscopic Cholecystectomy. World Journal of Surgery, 19, 753-756.
https://doi.org/10.1007/BF00295923
[18]  Torkington, J., Pereira, J., Chalmers, R.T. and Horner, J. (1998) Laparoscopic Cholecystectomy, Bile Duct Injury and the British and Irish Surgeon. Annals of the Royal College of Surgeons of England, 80, 119-121.
[19]  Pellegrini, C.A., Thomas, M.J. and Way, L.W. (1984) Recurrent Biliary Stricture: Patterns of Recurrence and Outcome of Surgical Therapy. American Journal of Surgery, 147, 175-180.
https://doi.org/10.1016/0002-9610(84)90054-0
[20]  Adamsen, S., Hansen, O.H., Funch-Jensen, P., Schulze, S., Stage, J.G. and Wara, P. (1997) Bile Duct Injury during Laparoscopic Cholecystectomy: A Prospective Nationwide Series. Journal of the American College of Surgeons, 184, 571-578.
[21]  Olsen, D. (1997) Bile Duct Injuries during Laparoscopic Cholecystectomy. Surgical Endoscopy, 11, 133-138.
https://doi.org/10.1007/s004649900315

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133

WeChat 1538708413