caa a22 4500 606246843 CHVBK 20210128101342.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-013-0915-3 doi (NATIONALLICENCE)springer-10.1007/s12262-013-0915-3 Bile Duct Injury—from Injury to Repair: an Analysis of Management and Outcome [Elektronische Daten] [Pramod Mishra, Sundeep Saluja, Mohammed Nayeem, Barjesh Sharma, Nilesh Patil] Despite advances in speciality care, mortality and morbidity remain the most important issues in the management of post-cholecystectomy bile duct injuries. We analysed the peri-operative management of post-cholecystectomy bile duct injuries to assess their outcomes. Of 150 patients with post-cholecystectomy bile duct injuries, 13 patients who presented with strictured hepaticojejunostomy were excluded from the analysis. The records of the remaining 137 patients were analysed for type of presentation, management and follow-up. Of 137 injuries, 88 were open and 49 were laparoscopic. Various presentations include acute bile duct injury (n = 5), bile collection (n = 45), external biliary fistula (n = 46) and stricture (n = 41). After initial management, three patients died (sepsis, n = 2; pseudoaneurysmal bleed, n = 1). Of 107 patients who underwent definitive repair, three died (portal hypertension, n = 2; sepsis, n = 1). At median follow-up of 30months, 100 patients had good outcome (grade A, B), and only 4 had bad outcome (grade C, D) as per McDonald grading. Peritonitis and sepsis in the early phase and portal hypertension and cirrhosis in the late phase are the main causes of mortality in patients sustaining bile duct injury during cholecystectomy. Successful management in a specialist hepatobiliary centre can limit the morbidity in more than 90% cases. Association of Surgeons of India, 2013 Bile duct injury nationallicence Benign biliary stricture nationallicence Hepaticojejunostomy nationallicence External biliary fistula nationallicence Mishra Pramod Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut Saluja Sundeep Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut Nayeem Mohammed Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut Sharma Barjesh Department of Gastroenterology, G B Pant Hospital and Maulana Azad Medical College, Room no. 203, 2nd floor, Academic Block, Jawaharlal Nehru Marg, 110002, New Delhi, India aut Patil Nilesh Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 536-542 0972-2068 77<536 2015 77 12262 https://doi.org/10.1007/s12262-013-0915-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-013-0915-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mishra Pramod Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut NATIONALLICENCE 700 1- Saluja Sundeep Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut NATIONALLICENCE 700 1- Nayeem Mohammed Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut NATIONALLICENCE 700 1- Sharma Barjesh Department of Gastroenterology, G B Pant Hospital and Maulana Azad Medical College, Room no. 203, 2nd floor, Academic Block, Jawaharlal Nehru Marg, 110002, New Delhi, India aut NATIONALLICENCE 700 1- Patil Nilesh Department of Gastrointestinal Surgery, G B Pant Hospital and Maulana Azad Medical College, Room no. 219, 2nd floor, Academic Block, 1, Jawaharlal Nehru Marg, 110002, New Delhi, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 536-542 0972-2068 77<536 2015 77 12262