A study of factors associated with bile duct injury in cholecystectomy operations
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 12
Abstract
Introduction: The biliary tract is a complex organ system that performs the simple though vital task of collecting, storing, and delivering bile to the gastrointestinal tract. Diseases of the biliary tract can be painful, debilitating, and occasionally life threatening. The development of the liver and biliary system in utero can result in multiple anatomic variations. An absolute knowledge of these anatomic variations with careful dissection and identification of structures at the time of surgery is a minimal requirement for the safe performance of any biliary surgery. Because of the great frequency with which the operation is performed, cholecystectomy remains the greatest source of post-operative biliary injuries. Aims and Objective: To study the clinical profile and Factors Associated With Bile Duct Injury in Cholecystectomy Operations. Methodology: A prospective analysis was done on all patients with an iatrogenic Bile Duct Injury (BDI) from June 2008 to July 2010. Retrospective study for BDI during the period January 2006 to May 2008 done using the available hospital records was also done. BDI as a complication of cholecystectomy done at M.S. Ramaiah hospitals and also those referred from elsewhere with BDI as a complication of cholecystectomy were included in the study. The case papers, referral letters, operative and postoperative records were scrutinized and data collected. BDI occurring as a complication of other surgeries apart from cholecystectomy, post ERCP, due to penetrating and blunt injuries to the abdomen, during Cholecystectomies done along with other surgeries-such as for pancreatic malignancy were excluded from the study. Result: A total of 731 cholecystectomies were carried out in the study period. The incidence of Bile duct injury was 3.42%. Most of the patients were from the age group of 50-59 (7) followed by 60-69 (6); 40-49 (5); 30-39 (3) and 20-29 (3). Majority of the patients were Female i.e.14 (56%). Majority of the bile duct injuries were seen in patients undergoing cholecystectomy for cholecystitis of > 72 hours duration. Among the 25 cases of BDI 80% were done laparoscopically and 20% were open cholecystectomies. Bile duct injuries mostly associated with; one (4%) had cholangitis, another (4%) had pancreatitis and two patients(8%) had choledocholithiasis. Three of the patients (12%) with BDI had cholecystitis of <72 hours duration. 28% of bile duct injuries were noted in patients with the above risk factors. Conclusion: Bile duct injury remains a dreaded complication in all cases of cholecystectomy, factors such as acute cholecystitis, cholangitis, pancreatitis, choledocholithiasis are contributory to occurrence of BDI and help of senior colleagues should be sought in cases with such co-morbidities. Detailed investigations to determine the site of injury is a must prior to any definitive repair.
Authors and Affiliations
Chetan Anand, Tridip Dutta Baruah
Keywords
Related Articles
- EP ID EP195822
- DOI -
- Views 90
- Downloads 0
A study on examiner variability in assessment by short essay type questions
Assessment of answer scripts of students is invariably associated with examiner variability. The present study is aimed to analyze the marks awarded for answer scripts of short essay type of questions for examiner variab...
A record based profile of cataract patients at tertiary medical college and hospital, Chengalpattu
Introduction: Globally, cataract has remained the major cause of blindness over the years. World Health Organization (WHO) reveals that 47.8% of global blindness is due to cataract. In India, cataract is the common cause...
Clinical pattern of diabetic foot lesions and their management
Introduction: In the years between 1958 and 1993, the number of people diagnosed with diabetes multiplied five – fold1. In 1994, 135 million patients world - wide were living with Diabetes mellitus. By the year 2025, it...
A study of associated injuries with fracture shaft of femur and tibia
Introduction: Diaphyseal femur fractures are mostly the result of high-energy trauma, for which reason they endanger life itself, account for important handicaps, and are usually associated with multilevel injuries. Thei...
Psychosocial effect of wine shop situated in residential area
Background: In India, Alcohol abuse is a major cause of mortality and morbidity. The mean age of initiation of alcohol consumption has decreased with passing of decade. Due to its large population, India has become the t...