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2018, Number 6

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Cir Cir 2018; 86 (6)

Surgical outcome and risk factors of bile duct injury repair following cholecystectomy

Martínez-Mier G, Luna-Ortiz HJ, Hernández-Herrera N, Zilli-Hernandez S, Lajud-Barquin FA

Language: Spanish
References: 28
Page: 491-498
PDF size: 192.76 Kb.


ABSTRACT

Background: Bile duct injury during cholecystectomy is a serious complication. Multiple factors may alter their outcome. Method: We retrospectively evaluated our results following bile duct injury surgery repair and possible poor outcome risk factors from January 2008 to January 2017. Results: 58 patients (72.4% female; mean age 41.8 years) were evaluated. 67.8% underwent open cholecystectomy as initial surgery. 79.3% of bile duct injury were diagnosed postoperatively. Mean referral time was 9 weeks and early (‹ 1 week) repair was performed in 27.6%. Most common lesion was Amsterdam type D (55.2%) and Bismuth-Strasberg E4 (34.5%). Morbidity was 39.6%. Biliary leak occurred in 10.3%, bilio-enteric stricture in 6.9% and recurrent cholangitis in 12.1%, with 3% perioperative mortality. There was an 81% treatment success rate (McDonald classification). Risk factors for complications were: low hemoglobin, low albumin, low alkaline phosphatase, biliary stents and E-3-E5 lesions (univariate analysis only). Risk factors for treatment failure were: previous repair outside our center, use of biliary stents and repair later than 1 week after lesion (univariate and multivariate analysis). Conclusions: Good efficacy and safety outcomes in bile repair surgery can be achieved in specialized centers. There are possible risk factors influencing outcomes that should be further validated.


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