title: Blunt trauma to the extrahepatic biliary tract. A multicenter study.
abstract: OBJECTIVE
  Blunt trauma to the extrahepatic biliary tract is a rare and challenging injury The purpose of this paper is to review our experience of these injuries, with special reference to their clinical presentation.
  
  
  METHODS
  In a retrospective multicenter study of the records of a trauma-admitting in three hospitals, seven patients with blunt extrahepatic biliary tract trauma were identified, one with combined gallbladder and common bile duct injuries and six with a ruptured gallbladder.
  
  
  RESULTS
  Except for the patient with the common bile duct injury developing peritoneal signs during observation and being operated 24 hours post-admission, all other patients underwent early laparotomy for shock, peritonitis or positive diagnostic peritoneal lavage (DPL) caused by associated injuries. The common bile duct injury was treated with suture repair over a T tube and the gallbladder injuries with cholecystectomy, except for two cases in which a cholecystostomy was performed.
  
  
  CONCLUSIONS
  In patients with blunt trauma, especially to the right upper quadrant, a high index of suspicion and liberal use of diagnostic studies to exclude an isolated extrahepatic biliary tract injury is recommended.
authors.affiliation: Second Department of Surgery, General Hospital ASCLEPEION Voulas, Athens, Greece.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Pikoulis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Daskalakis
authors.forename: Efthimios D
authors.initials: ED
authors.lastname: Avgerinos
authors.forename: Evangelia
authors.initials: E
authors.lastname: Gougoudi
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karavokyros
authors.forename: Ari
authors.initials: A
authors.lastname: Leppäniemi
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Pavlakis
authors.forename: Dimitrios K
authors.initials: DK
authors.lastname: Filippou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Psalidas
authors.forename: Nicolas
authors.initials: N
authors.lastname: Condilis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Tsatsoulis
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000601:surgery*