Predictors of satisfactory outcome following repair of postcholecystectomy bile duct injury

Hassan, Ramy A.; Omar, Mohamed I.; Jabir, Murad A.; Elkoussy, Ahmed M.; Aly, Mahmoud S.; Taha, Ahmed M.I.

doi:10.4103/ejs.ejs_68_20

Predictors of satisfactory outcome following repair of postcholecystectomy bile duct injury

Authors

Abstract

Background
We aim to report the short-term and long-term outcome of surgical repair following Roux-en-Y hepaticojejunostomy for postcholecystectomy bile duct injury (BDI) in a tertiary hepatobiliary center in Upper Egypt (Assiut University).
Patients and methods
A retrospective study was conducted on all patients diagnosed with postcholecystectomy BDI during the period 2014–2018 at Al-Rajhi Liver Institute, Assiut University, who had undergone surgical repair of BDI. Patients were grouped according to the time interval between previous surgery and surgical repair into two groups: group 1: time interval less than or equal to 6 weeks and group 2: time interval more than 6 weeks.
Results
Of 43 patients enrolled, 18 were in group 1 and 25 in group 2. The overall incidence of stricture was 14% (27.9% in group 1 and 4% in group 2), which is statistically significant (=0.026). Other factors that have a significant association with incidence of stricture included bilirubin level. On multivariate analysis, none of these factors had a significant effect on the development of biliary stricture.
Conclusion
We believe that timing of repair of BDI following cholecystectomy has a significant effect on the outcome of repair. Moreover, best results in biliary reconstruction can be achieved in a specialized hepatobiliary center.

Keywords