Iatrogenic bile duct injuries: management of ten patients

The bile duct injuries rose from 0.1%-0.2% to 0.4%-0.7% from the era of open cholecystectomy to the era of laparoscopic cholecystectomy. Many classifications categorized the biliary tract injury, but none was universally accepted. In this study, 10 patients with iatrogenic major bile duct injuries were managed in Al Rahba General Hospital, UAE (April 2003 to December 2007). They were 8 females & 2 males with a mean age of 46.5 years and a mean hospital stay of 19.4 days. Four patients were initially operated upon for laparoscopic cholecystectomy and six were initially operated on elsewhere. Intraoperative bile duct injury was discovered in only 2 cases, and in 8 patients, bile duct injury was discovered in the postoperative period. Roux en Y hepaticojejunostomy was the treatment of choice for 6 patients, and 4 patients was choledochodudenostomy in one patient, left hepaticojejunostomy in another, end to end anastomosis of common bile duct over a T tube in a third patient, and removal of a clip in the last patient. There was no mortality, but in the first year postoperative follow up, 2 developed cholangitis which responded to antibiotic.