Bile duct injury during laparoscopic cholecystectomy: Experience from a tertiary care hospital of Bihar, India

Abstract

Introduction: Bile duct stone is a common disease. In the case of United States, around 30 million people are affected by bile duct stone disease annually, and around 750,000 cholecystectomies are performed per year. The aim of the study is to know the risks, incidence, types, causes of BDIs, their timing and clinical presentations, various imaging modalities, and management by various methods. Materials and Methods: An observational study was carried out on 100 patients at Department of General Surgery, Darbhanga Medical College and Hospital, Laheriasri, Bihar, India. All patients who underwent laparoscopic cholecystectomy with BDIs were observed and followed up. The study was conducted over a period of one year From July 2020 to June 2021 included all cases of BDI during this duration. Prior approval was obtained from the Institutional Ethics Committee. Informed written consent was obtained from each patient before participation in the study. Results: A total of 100 patients were observed in the study period. The mean age of these patients was 43.8 ± 18.2 years with a female preponderance. The conversion of laparoscopy to open surgery was done among 12 cases. In 9 cases, this was done because of BDI, and, in 3cases, it was done because of short cystic duct with adhesions, inflammation, and difficulty in laparoscopy. BDI was observed in 5 patients and BL occurred in another 4 cases. Of 5 cases of BDI, 4 cases were detected intraoperative and 1 case was detected postoperatively. The cases detected at the time of surgery were managed surgically by end-to-end anastomosis over a T-tube and Roux-en-Y hepaticojejunostomy. Conclusion: The surgeon doing laparoscopic cholecystectomy should be aware about management of such injuries, and long-term follow-up should be done for such patients.