Research Article
Current Scenario of Postcholecystectomy Bile Leak and Bile Duct Injury at a Tertiary Care Referral Centre of Nepal
Table 1
Demographics, details of index operation, presentation, and staging of injury.
| Parameters | Total patients, n = 18 | Age (years), mean (range) | 40 (16–55) | Male : female (M : F) | 7 : 11 |
| Place of injury | | Outside hospital | 5 (27.8%) | In hospital | 13 (72.2%) |
| Indication for cholecystectomy | | Biliary colic | 9 (50%) | Acute cholecystitis | 4 (22.2%) | Mucocele | 4 (22.2%) | Xanthogranulomatous cholecystitis | 1 (5.5%) |
| Surgery started as | | Open | 3 (16.7%) | Laparoscopic | 15 (83.3%) | Any conversion from laparoscopy to open | 0 |
| Methods of cholecystectomy | | Dissection of hepatocystic triangle first | 13 (72.2%) | Unknown | 5 (27.8%) |
| Methods of cystic duct identification | | Critical view of safety | 11(61.1%) | Infundibular approach | 1(5.5%) | Top-down | 1(5.5%) | Unknown | 5(27.8%) |
| Detection of injury | | Intraoperative | 4 (22.2%) | Postoperative | 14 (77.8%) |
| Injury occurred during which part of procedure | | Open | 3 (16.7%) | Laparoscopic | 15 (83.3%) |
| Management of recognized injury | | End-to-end anastomosis + T-tube | 1(5.5%) | Hepaticojejunostomy | 2 (11.1%) | Suture closure of rent in common hepatic duct | 1 (5.5%) |
| Indication for referral (n = 15) | | Jaundice | 5 (29.4%) | Intra-abdominal sepsis | 8(35.3%) | Biliary fistula | 2 (11.8%) |
| Time from index operation to referral for surgical repair | | Intraoperative | 3 (16.7%) | 0–3 days | 3(16.7%) | 4–7 days | 3(16.7%) | 8 days–6 weeks | 5 (27.8%) | 6 weeks–3 months | 4 (22.2%) |
| Staging of injury | | A | 9 (50%) | D | 1 (5.5%) | E1 | 5(27.8%) | E2 | 1 (5.5%) | E3 | 2 (11.1%) | Vasculobiliary injury | 0 | Other organs injured | 0 |
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