Online ISSN: 2515-8260

Keywords : bile duct injury


A STUDY OF BILIARY TRACT INJURIES OCCURING AS A COMPLICATION IN CHOLECYSTECTOMY AND THEIR MANAGEMENT

Dr. Rambabu Pailla, Dr. Chouta Teja Priya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3180-3190

Background and Objectives:  To evaluate the prevalence of bile duct as well as other biliary system injuries resulting after cholecystectomy in our hospital, along with the factors that contribute to the injuries and the way they are treated.
Methods: All patients between 2019 and 2021 who had an iatrogenic biliary tract injury underwent a prospective analysis. Gender, age, the presence of abnormal anatomy (extra-hepatic bile duct and vascular anatomy), the presence of gall stone pancreatitis, acute cholecystitis or cholangitis, the time between cholecystectomy and recognition of biliary tract injury, the time from injury to definite management, the type of injury, and the mode of management, such as endoscopic retrograde cholangiography, are all relevant factors for injuries sustained
Results: Injury to the bile duct occurred 2.52% of the time. Patients undergoing cholecystectomy for cholecystitis lasting longer than 72 hours tended to suffer from the majority of bile duct damage. The likelihood of bile duct injury was enhanced by elements including acute cholecystitis, cholangitis, and choledocholithiasis. Most of the injuries were discovered right after surgery. The most frequent site of injury was the common hepatic duct. The majority of BDI cases were treated with a final repair, which was aided by radiological treatments like ERCP and stenting.
Conclusion: Because of the steep learning curve of laparoscopic surgery, bile duct injury rates have been found to be higher in our institution during cholecystectomy. The best chance of recovery is provided by early detection, repair, and a multidisciplinary strategy

Assessment of incidence of CBD injury who underwentLaparoscopic cholecystectomypatients

Dr.Nayan Pancholi, Dr.Latif Bagwan,Dr.Sandipkumar Chaudhari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 584-587

Background:Laparoscopic cholecystectomy (LC), one of the most commonly performed surgical
procedures worldwide is accepted as the gold standard in the treatment of symptomatic gallstones.
The present study was conducted to assess incidence of CBD injury who underwent LC.
Materials & Methods:180 patients who underwent laparoscopic cholecystectomy of both genders
were included. Predictors of CBD injury were assessed based on grading of degree of difficult LC and
visualization of critical view of safety (CVS). BDI was classified according to Strasberg
classification.
Results: Out of 180, males were 110 and females were 70. Diagnosis was acute cholecystitis in 90,
chronic cholecystitis in 40, empyema gall bladder in 30 and mucocele gall bladder in 20 cases. Degree
of difficulty was mild in 46, moderate in 84, severe in 28 and extreme in 22. CVS was seen in 160.
The difference was significant (P< 0.05). Type of bile duct injury was type A in 5, type B in 1, type D
in 2 and type E4 in 3 patients. The difference was significant (P< 0.05).
Conclusion: Majority of bile duct injuries, results mainly from the surgeon’s inexperience,
misinterpretation of anatomy and poor surgical technique.

Open cholecystectomy versus laparoscopic cholecystectomy: A comparative study at north Indian based teaching hospital

Dr. Vipin Kumar, Dr. E.D. Reddy, Dr. Chandra Shekhar, Dr. Madhu Sinha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 586-591

Background: Gallstone disease (GSD or Cholelithiasis) is a significant health problem
both worlds over (in both developing and developed nations). The main objective is
Laparoscopic cholecystectomy has rapidly become established as the popular alternative to
open cholecystectomy, but it should have a safety profile better than of open procedure.
Aims and objectives: The aim of this study was to compare conventional cholecystectomy
and laparoscopic cholecystectomy with respect to duration of procedure, complications,
postoperative pain, analgesic requirement and period of hospital stay.
Materials and Methods: This study consists of 52 patients who have undergone gallbladder
removal in GMC Budaun. 26 patients who have undergone laparoscopic cholecystectomy
and 26 patients who have undergone open cholecystectomy for a study period of one year
have been taken into the study In method 52 consecutive patients below 70 years presenting
with calculous cholecystitis with no evidence of CBD stones were randomized to undergo
open and laparoscopic cholecystectomy.
Results: 9 patients of LC and 10 patients of OC were males. Among LC 16 patients were
females and among OC group 15 were females, 28% of patients who underwent open
surgery had complications and 16% of patients who underwent laparoscopic surgery had
complications. The overall percentage of complications is lesser in laparoscopic surgery
than open surgery, The VAS was median grade 2 in LC group as compared to median
grade 4 in LC group. The NSAID’S were used for more days in OC group compared to LC
group, 23 patients who underwent laparoscopic cholecystectomy were discharged before 5
days. All patients who underwent OC stayed >5 days in hospital.
Conclusion: Herewe conclude in results, the duration of pain, rate of complications and
hospital stay were significantly lower in laparoscopic group. However the main advantages
of LC were reduced postoperative pain with less duration of analgesic intake, more rapid
recovery, reduced hospital stay and early return to normal work.