Elsevier

HPB

Volume 2, Issue 3, 2000, Pages 321-324
HPB

Survival and quality of life after bile duct reconstruction for iatrogenic injury

https://doi.org/10.1016/S1365-182X(17)30753-0Get rights and content
Under an Elsevier user license
open archive

Background

The overall acceptance of laparoscopic cholecystectomy has increased the number of operations performed worldwide. Duct injury continues to occur with a prevalence of 0.3–0.6%. The present paper evaluates the survival and quality of life of patients following operative repair.

Methods

In a 9-year period, 122 patients underwent bile duct reconstruction. Of these patients (mean age 38 years), 80% sustained the injury during an open operation and 42 during a laparoscopic operation. Quality of life was evaluated in the postoperative period.

Results

All 122 patients were treated surgically by means of Roux-en-Y hepaticojejunostomy. Transhepatic stents were used in all but 10 cases. Six patients had independent left and right hepatic duct anastomosis, and 24 had partial resection of segment IV of the liver to improve exposure of the hilus. Mortality rate was 1.7%. After removal of the transhepatic stent, in 16% of cases radiological manipulation was required to remove debris and stones or to dilate the anastomosis. Of the total patients, 101 (83%) were completely rehabilitated, both clinically and biochemically.

Discussion

Bile duct injury has a good prognosis in specialist tertiary care centres. Hepaticojejunostomy is the procedure of choice with a transhepatic stent when needed. Full rehabilitation can be achieved in over 80% of patients.

Keywords

bile duct injury
biliary tract reconstruction
cholecystectomy

Cited by (0)