Blunt trauma to the extrahepatic biliary tract. A multicenter study.
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.
Pikoulis
Emmanouil
E
Second Department of Surgery, General Hospital ASCLEPEION Voulas, Athens, Greece.
Daskalakis
Panayiotis
P
Avgerinos
Efthimios D
ED
Gougoudi
Evangelia
E
Karavokyros
Ioannis
I
Leppäniemi
Ari
A
Pavlakis
Emmanouil
E
Filippou
Dimitrios K
DK
Psalidas
Nikolaos
N
Condilis
Nicolas
N
Tsatsoulis
Panayiotis
P
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*