Impact of concomitant vascular injury on the outcome of bile duct injury

Ahmed Sallam,Ibrahim Marwan, Motasem M. Ali, Abdelrahman Gamal, Saleh Khairy,Islam Ayoub,Ahmed Attia, Ghadier Saaed,Osama Hegazy

EGYPTIAN JOURNAL OF SURGERY(2023)

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Abstract
BackgroundCompared with open cholecystectomy, the frequency of iatrogenic bile duct damage (bile duct injury) has almost doubled as laparoscopic cholecystectomy (LC) has become more prevalent. The authors aimed to analyze the prevalence of postcholecystectomy vasculobiliary injury and its influence on illness and death. MethodsMedical records were reviewed on 50 consecutive patients with iatrogenic bile duct injuries from either open or laparoscopic cholecystectomy who were treated at the National Liver Institute, Menoufia University between January 1, 2020 and October 31, 2022.The medical records were examined for patient demographics and preoperative and postoperative clinical scenarios, which included symptoms, operative procedures, diagnostic methods, operative repairs, length of ICU and Hospital stays, postoperative follow-up, short- and long-term complications, need for radiographic or operative revision, and patient mortality. ResultsThe studied patients were allocated into two groups, according to presence of concomitant vascular injury; group A: cases did not develop concomitant vascular injury, group B: cases developed concomitant vascular injury. Vascular injury was significantly elevated in males than those without vascular injury (P=0.027). There were no significant variance among the studied groups as regard Hospital stay and ICU admission. There was no significant variance among the studied groups as regard short-term complications. There was a significant variance among the studied groups as regard long-term complications (P=0.003). Right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury. ConclusionsConcomitant vascular injury postcholecystectomy prevalence was significantly associated with long-term complications; right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury.
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Key words
bile duct,concomitant vascular injury
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