 Possible injury sites during a Cholecystectomy (removal of the gall bladder). Injuries can occur at any level and are often associated with leakage of bile, occasionally sepsis and stricture formation. |
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What are Bile Duct Injuries?
Most bile duct injuries occur during the removal of the gall bladder (Open or Laparoscopic Cholecystectomy). Approximately 1 of every 150 patients undergoing a cholecystectomy will have an injury. In experienced hands this rate is much lower but can still happen to the best of surgeons, especially when the gall bladder is extremely inflamed, distorting the anatomy and making the surgical dissection exceedingly difficult.
What happens if one has an injury of the bile ducts?
If these injuries are identified during the operation, they are best fixed at the same session. If the operating surgeon is not comfortable at repairing these, it is imperative that he or she seek specialist help. Sometimes these injuries can be rather subtle and missed during surgery, and patients are diagnosed in the early post-operative period. Very rarely, they can present several years later. These are both often complex problems for the non-specialized HPB (hepato-pancreato-biliary) surgeon. Surgeons who are specialized in HPB surgery obtain better results in the treatment of this problem than those who are not. A multidisciplinary approach, i.e. a collaboration of surgeons, interventional radiologists, and interventional gastroenterologists is essential to a successful outcome. At the Liver and Pancreas Center, we provide comprehensive evalutaion and complete all round care for these injuries and take great pride in being able to provide the highest level of care for these complex problems.
What are Bile Duct Strictures?
Most bile duct injuries if treated inadequately will contract to cause strictures (narrowing). While some of these can be dealt with stents and progressive dilatation, a good percentage of these will need surgical repair. If there has been no prior injury or insult and this is a new onset unexplained stricture, this needs immediate attention as most of these tend to have a malignant potential . A multidisciplinary approach, i.e. a collaboration of surgeons, interventional radiologists, and interventional gastroenterologists is essential to a successful outcome. Surgery is often the best way to take care of these problems. At the Liver and Pancreas Center, we provide comprehensive evaluation for these strictures and take great pride in being able to provide the highest level of care for these complex problems.
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