Management of major bile duct injury after laparoscopic cholecystectomy: a case report

Author: 
Khalid Javed Abid, Sadaf Ishaque, Ifrah Naeem and Tahir Saleem Ch

Introduction: Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Several series have described a 0.5% to 0.6% incidence of bile duct injury during laparoscopic cholecystectomy. The aim of this study was to analyze the presentation, characteristics, related investigation, and treatment results of major bile duct injuries after laparoscopic cholecystectomy. Case presentation: A case of a 35-year-old woman with a common bile duct injury after laparoscopic cholecystetcomy is presented. A Roux en Y hepaticojejunostomy was performed after endoscopic retrograde cholangiopancreatographies and magnetic resonance cholangiographies to delineate the biliary anatomy and assess the level of injury. She again underwent revision of hepaticojejunostomy 6 years after previous surgery for denovo stone formation. Conclusion: Early recognition and an adequate multidisciplinary approach are the cornerstones for the optimal final outcome. Suboptimal management of injuries often leads to more extensive damage to the biliary tree and its vasculature. Early referral to a tertiary care center with experienced hepatobiliary surgeons and skilled interventional radiologists would appear to be necessary to assure optimal results.

Paper No: 
1247