Early vs. delayed repair of isolated segmental, sectoral and right hepatic bile duct injuries
Qiang Huang1, Feng Shao, Lu-Jun Qiu
1Department of Hepato-Biliary Surgery Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China. shenyijasmine2010@yahoo.com.cn
Background/Aims:
To compare the outcome of early (within the first 2 weeks) and delayed (between 2 weeks and 24weeks) repair of segmental, sectoral and right hepatic bile duct injuries (SSRBDI).
Methodology:
Data on all patients with SSRBDI were collected prospectively. In the absence of infection, biliary peritonitis or biliary fistula, repair was considered within 2 weeks.
Results:
Between June 1984 and June 2009, 282 patients were referred with injury to the bile tree. Of these 282 patients, 51 were segmental, sectoral and right hepatic bile duct injuries (SSRBDI). Repair of the SSRBDI injury had been attempted in 8 patients before referral. Of the 43 patients with no previous repair, two were managed without surgery and 41 required subsequent surgical reconstruction of the ductal injury. Within the first 2 weeks after injury, 19 patients underwent early biliary repair. Between 2 weeks and 24 weeks, 22 patients underwent delayed repair. Successful repair was possible in 18 of 19 early repairs compared with 20 of 22 delayed repairs (p=0.669).
Conclusions:
Early repair within the first 2 weeks achieved a similar result to that of delayed repair when repair of SSRBDI was undertaken in unit experienced in the management of biliary injury.
