Pattern of Presentation of Iatrogenic Biliary Injury Following Laparoscopic Cholecystectomy ()
Affiliation(s)
1Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh.
2Department of Surgery, Shaheed M. Monsur Ali Medical College Hospital, Shirajgonj, Bangladesh.
3Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh.
4Department of Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
5National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
6Department of Laboratory Medicine, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh.
7Mugda Medical College and Hospital, Dhaka, Bangladesh.
ABSTRACT
Background: Cholecystectomy is one of the most now common abdominal surgeries performed every day. The incidence of bile duct injury (BDI) following open cholecystectomy is only 0.1% - 0.2%. After the introduction of laparoscopic cholecystectomy, the incidence has gone up to 0.4% - 0.7%. The present study is a prospective analysis of all patients with bile duct injury who were admitted to Dhaka Medical College Hospital during or at a variable period following cholecystectomy. Methods: To determine the pattern of presentation of iatrogenic biliary injury following cholecystectomy in the department of surgery of Dhaka Medical College Hospital, a total of 30 patients were purposively selected from May 2018 to November 2018. Patient particulars, records of physical and clinical evaluation, and operative details were collected by individual researchers. Data analysis was done by SPSS for windows version 21. Results: BDI was found very common among the age group 21 - 30 yrs (36%) and female dominant (60%). Majority of the patients presented with abdominal pain (96%), intra-abdominal collection (88%), biliary peritonitis (68%), cholangitis (60%), and obstructive jaundice (40%), and biliary fistula (40%). Laparoscopic cholecystectomy (84%) was the principal cause of biliary injury in our study. 48% of patients experienced clinical features within 7 days post-cholecystectomy. Per-operative diagnosis was done in only 12% of cases. 44% of patients in this study were recognized as Bismuth grade-3, followed by 36%, grade-2 patients. Management outcomes included wound infection (41.66%), minor bile leak (25%), peritonitis (8.33%), and renal impairment (8.33%). Conclusion: The effect of BDI is an extremely distressful clinical condition for the patients and their family members, hence proper care and management protocol should be followed.
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Islam, M.A., Al Galib, Md.S., Alam, Md.M., Khan, Md.S., Akhanda, M.T.A., Hossain, S., Siddika, L., Khan, M.E.H. and Jamal, A.B.Md (2022) Pattern of Presentation of Iatrogenic Biliary Injury Following Laparoscopic Cholecystectomy.
Open Journal of Clinical Diagnostics,
12, 55-62. doi:
10.4236/ojcd.2022.124006.
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