Prevalence of Iatrogenic Bile Duct Injury Following Open and Laparoscopic Cholecystectomy Treatment Outcomes

Background and Aim:Iatrogenic bile duct injuries (IBDI) continue to be a difficult diagnostic and therapeutic problem. The prevalence of iatrogenic IBDI increased with the laparoscopic technique introduction for the cholecystolithiasis treatment. The study's objective was to determine the frequency of iatrogenic bile duct injuries (IBDI) following open and laparoscopic cholecystectomy treatment outcomes. Materials and Methods: This retrospective observational study was carried out on 131 bile duct injuries sustainable patients who underwent laparoscopic cholecystectomy at General Hospital, Lahore for the duration of six months from May 2021 to October 2021. All the patients who satisfied the inclusion criteria were enrolled in this study. Ethical approval and informed consent were taken from the institutional ethical committee and individual respectively. The data outcomes such as time details of laparoscopic cholecystectomy and injuries recognition, injury types, injuries definitive repair time, IBDI management, intraoperative cholangiography use, post-operative complications, laparoscopic cholecystectomy to open cholecystectomy conversion, bile duct injury, morbidity, postoperative outcomes, and mortality rate were recorded. SPSS version 20 was used for data analysis. Results: A total of 131 referred patients were treated for iatrogenic bile duct injury caused by open cholecystectomy (n = 60), and Laparoscopic cholecystectomy (n = 71). During laparoscopic cholecystectomy, bile duct injuries were identified in only 28 (39.4%) patients. Following the LC conversion to open operation, 50%successive procedures were deemed ineffective. In case of no recognizedinjury during LC, bile leak/peritonitis was developed in 70% of patients, with nearly half being referred and the remainder underwentvarious procedures recommended by their surgeon.The rest of the patient’sdeveloped and abnormal liver function, jaundice, cholangitis. About 43% of patients underwent IOC, but two-thirds of patients did not have an injury. Laparoscopic cholecystectomy developed bile duct injury was more severe compared to the IBDI in open cholecystectomy. One patient died during definitive repair and 92% of patients were recovered without any complications. Conclusion:The iatrogenic bile duct injury increasing rate is a major surgical intervention challenge. Multidisciplinary treatment should be followed for iatrogenic bile duct injury prevention and management. Bile duct injury could be effectively treated when suspected and confirmed patients are referred to tertiary care hospitals. Keywords: Iatrogenic bile duct injuries; Laparoscopic Cholecystectomy; Complications