Presentation Of Post Cholecystectomy Bile Duct Injuries In A Tertiary Care Hospital

Qaiser Naveed Haral, Ammad Ud Din Nasir, Arslan Hamid, Muhammad Shoaib Khan, Rashid Zahid Ali, Arwah Mansoor, Hassan Mumtaz
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Abstract

Introduction:The occurrence of iatrogenic bile duct injuries is few, however potentially linked to life-threatening complications, particularly following the advent of laparoscopic cholecystectomy. Aims &Objectives: To evaluate the presentation of post-cholecystectomy bile duct injuries in a tertiary care hospital. Place and Duration of Study: This study was done in the Department of General Surgery at Combined Military Hospital Rawalpindi from Nov 2020 to Dec 2021. Material &Methods: This cross-sectional study was conducted on 15 subjects with post-cholecystectomy bile duct injuries.All the patients who presented to the emergency department and outdoor were included in the study and had post-cholecystectomy CBD injuries. Laparoscopic and open BDI were classified according to Strasberg classification. In descriptive statistics, mean, and standard deviation was used, and in qualitative analysis, frequency and percentages were calculated with the help of the SPSS 23 version, a p-value of? 0.05 was considered significant. Results: In our study, 5 (33.3 %) males and 10 (66.7 %) were females, with a mean age of 47.27 ± 4.79. The presentation on the admission of patients was as follows, 3 (20.0 %) patients had biloma, 4 (26.7 %) had jaundice, 2 (13.3 %) had abdominal pain, 1 (6.7 %) had external biliary fistula, 3 (20.0 %) had Biliary peritonitis and 2 (13.3 %) had a fever. Conclusion: The most common consequence of cholecystectomy was complete resolution, but bile leak and major duct damage cause considerable morbidity, death, and healthcare expenditures. Better outcome was achieved when a nonprimary and skilled hepatobiliary surgeon repaired severe bile duct damage.
一家三级医院胆囊切除术后胆管损伤的报告
医源性胆管损伤的发生很少,但可能与危及生命的并发症有关,特别是在腹腔镜胆囊切除术出现后。目的:评价某三级医院胆囊切除术后胆管损伤的临床表现。研究地点和时间:本研究于2020年11月至2021年12月在拉瓦尔品第联合军事医院普外科完成。材料与方法:对15例胆囊切除术后胆管损伤患者进行横断面研究。所有到急诊科和户外就诊的患者都被纳入研究,并有胆囊切除术后的CBD损伤。采用Strasberg分型法对腹腔镜下和开放式BDI进行分类。描述性统计使用均值和标准差,定性分析使用SPSS 23版计算频率和百分比,p值为?0.05为显著性。结果:本组患者中男性5例(33.3%),女性10例(66.7%),平均年龄47.27±4.79岁。患者入院情况如下:胆囊瘤3例(20.0%),黄疸4例(26.7%),腹痛2例(13.3%),胆外瘘1例(6.7%),胆道性腹膜炎3例(20.0%),发热2例(13.3%)。结论:胆囊切除术最常见的结果是完全消除,但胆漏和主要胆管损伤引起相当大的发病率、死亡率和医疗费用。当一个熟练的非原发性肝胆外科医生修复严重的胆管损伤时,效果更好。
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