Clinical Study
Iatrogenic Biliary Injuries: Multidisciplinary Management in a Major Tertiary Referral Center
Table 4
Surgical management of biliary injuries.
| | Surgical procedure | | % |
| | Urgent surgery (62 patients) | | | | Ligated slipped cystic duct (open or laparoscopic) | 12 | 2.5% | | Peritoneal lavage and external biliary stent | 30 | 6.4% | | CBD repair over T-tube in cases of injuries detected intraoperatively (on-table repair) | 13 | 2.7% | | Bilioenteric anastomosis in cases of injuries detected intraoperatively (on-table repair) | 7 | 1.5% | | Elective surgery (136 patients) | | | | Choledocholithotomy and CBD repair over T-tube splint | 8 | 1.7% | | Choledocholithotomy, strictureplasty, and T-tube splint | 12 | 2.5% | | CBD strictureplasty and repair over T-tube splint | 9 | 2% | | Bilioenteric anastomosis by Roux-en-Y hepaticojejunostomy (96 patients) | | | | Bismuth I injuries | 40 | 8.5% | | Bismuth II injures | 31 | 6.6% | | Bismuth III injuries (Hepp-Couinaud hepaticojejunostomy) | 18 | 3.8% | | Bismuth IV injuries with | | | | 2-duct anastomosis with transanastomotic stent | 4 | 0.8% | | 3-duct anastomosis with transanastomotic stent | 3 | 0.6% | | Redo surgery | | | | Repeated bilioenteric anastomosis for postoperative stricture and stenosis | 11 | 2.3% |
| | Total | 198 | 42% |
|
|
CBD: common bile duct.
|
