Frequency of Iatrogenic Bile Duct Injuries during Laparoscopic Cholecystectomy

Abstract

Objective: to assess the frequency of iatrogenic bile duct injuries during laparoscopic cholecystectomy Study Design: Prospective Study. Study Place and Duration: Department of General Surgery Nishtar Hospital Multan from 15^th June 2017 to 31^st July 2018. Material and methods: A total of 450 patients presented during this duration for laparoscopic cholecystectomy. A performa was designed to record all the measured data during the whole procedure. Data was collected by the consultant himself. All the patterns, mechanisms and management of the iatrogenic injuries occurring to the bile ducts were assessed. Statistical analysis was done for the data obtained at the end. Computer software SPSS version 23 was used for this purpose. Frequency and percentage was calculated for qualitative variables while mean and standard deviation was calculated for quantitative variables. Results: During laparoscopic cholecystectomy, 43 (9.5%) patients withstood multiple types of bile duct injuries. Out of the patients receiving injuries, CBD was clipped in 11 (25.6%) patients who were recognized while in another 5 (11.6%) patients CBD clipping was not recognized. Right hepatic duct was transected in 6 (13.9%) patients while 13 (30.2%) patients received other types of partial injuries to major bile ducts. Hole was formed due to diathermy in CBD in 5 (11.6%) patients and in RHD in 3 (6.9%) patients. Conclusion: Regardless of the advancements in the technique and experience of laparoscopic cholecystectomy the ratio of iatrogenic bile duct injuries is still high among the most parts of the world and these are life threatening in nature.

Keywords: Iatrogenic, Bile, Duct, Injury, Laparoscopic, Cholecystectomy, gallbladder, biliary tree