[Management of patients with iatrogenic bile duct injury].
OBJECTIVE
The aim of this study is to present an analysis of 30 patients with major bile duct injuries in a single hospital centre.


METHODS
From January 2001 to December 2006, a prospective database was kept of all patients with a bile duct injury (BDI) following laparoscopic cholecystectomy (LC). Patients' charts were reviewed to analyse perioperative surgical management.


RESULTS
Over 6 years, 30 patients were treated for a major BDI. Patient demographics were not notable for 16 women (53%) and 14 men (47%) with a mean age of 58.9 years. Twenty of them sustained their BDI at another hospital. The mean interval from the time of BDI to referral was 17.4 days. A total of 30 patients underwent definitive biliary reconstruction, including 17 hepaticojejunostomies (56.7%), 8 end-to-end repairs (20%), 2 choledochoduodenostomies (6.7%), 3 liver transplantations (10%), 1 hepatectomy and 1 Whipple (3.3%). There were 2 deaths in the postoperative period (6.7%). Thirteen (43.3%) sustained at least 1 postoperative complication. The most common complications were cholangitis (20%), and intra-abdominal abscess/biloma (23.3%). The mean postoperative length of stay was 17.46 days.


CONCLUSIONS
Bile duct injury is a serious complication that affects mostly individuals with benign disease. Various subsequent procedures (surgical and/or endoscopic) are almost always necessary for its correction, with a high socioeconomic cost that imposes great suffering on the patients and their relatives. Clearly, all efforts should be made to prevent such accidents.
González Rodríguez
Francisco Javier
FJ
Unidad de Trasplante Abdominal, Servicio de Cirugía General, Hospital Clínico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. fran.padroso@gmail.com
Bustamante Montalvo
Manuel
M
Conde Freire
Rogelio
R
Martínez
Jorge
J
Rodríguez Segade
Faustino
F
Varo
Evaristo
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies