MANAGEMENT OF BILE DUCT INJURIES; CONVENTIONAL AND SURGICAL METHODS AND THEIR SHORT OUTCOME

Background: Bile duct injury (BDI) which is occurring during cholecystectomy is the most serious complication of such procedure. Moreover, suboptimal management of BDI might result in biliary peritonitis, multi-organ failure, and recurrent attacks of ascending cholangitis, secondary biliary cirrhosis and portal hypertension later on. Aim of the work: was to evaluate different modalities of management of Bile duct injuries (BDI) which are following cholecystectomy and discuss their short outcome. Methods: the current study includes 28 cases having iatrogenic bile duct injuries which were managed at the Department of General Surgery, Zagazig University Hospitals in the period from October 2016 and October 2018. Results: all our 28 patients were diagnosed by various types of bile duct injuries. We have performed therapeutic ERCP for 10 patients; where sphincterotomy and stenting were done; we performed roux-en-Y hepaticojejunostomy for twelve patients and performed end-to-End anastomosis for five patients. Patients that underwent therapeutic ERCP were discharged after 1-2 days of follow up. But cases which need surgical intervention need a longer period of hospitalization with an average of 20 days. Conclusion: Endoscopic management of BDI by ERCP is considered a suitable and less invasive surgical procedure which carries low morbidity; however surgical intervention is still mandatory in few cases of BDI which could not be managed by ERCP.