2024 | Mohamed Hossam El-Din Zidan, Mostafa Seif-Elddeen, Abdelhamid A Ghazal, and Mustafa Refaie
This retrospective study analyzed 35 cases of bile duct injuries (BDIs) following cholecystectomy, including 54.3% laparoscopic cholecystectomy (LC) and 45.7% open cholecystectomy (OC). Patients were classified using the ATOM classification, with 45.7% classified as main bile duct injuries (MBDI) and 54.3% as non-main bile duct injuries (NMBDI). Only 2.9% of cases involved vasculobiliary injury (VBI). Intraoperative diagnosis (Ei) occurred in 28.6% of cases, early postoperative diagnosis (Ep) in 62.9%, and late postoperative diagnosis (L) in 8.6%. LC was associated with 84.2% of NMBDI and 18.8% of MBDI, while OC was associated with 81.3% of MBDI and 15.8% of NMBDI. Clavien-Dindo classification showed 68.6% of cases in Class IIIb, 20% in Class I, 5.7% in Class V (mortality), 2.9% in Class IIIa, and 2.9% in Class IV. Early detection and management were associated with lower morbidity and mortality. Diagnostic laparoscopy was linked to lower morbidity and better outcomes. A proper reporting checklist is recommended to improve injury identification.
BDI remains a significant complication of cholecystectomy, with incidence ranging from 0.2 to 1.3%. The ATOM classification is now widely used to define BDI. Early diagnosis and management are crucial for better outcomes. Diagnostic laparoscopy is effective in identifying and managing BDI. Re-laparoscopy is useful for assessing and managing BDI, especially in minor cases. The study highlights the importance of early detection, proper classification, and appropriate management strategies. The use of the ATOM classification improved the accuracy of injury classification. The study also emphasizes the need for a standardized reporting system to enhance the identification and management of BDI. The results indicate that early diagnosis and management significantly reduce morbidity and mortality. The study concludes that further research is needed to develop a proper checklist for BDI reporting and to improve the management of BDI.This retrospective study analyzed 35 cases of bile duct injuries (BDIs) following cholecystectomy, including 54.3% laparoscopic cholecystectomy (LC) and 45.7% open cholecystectomy (OC). Patients were classified using the ATOM classification, with 45.7% classified as main bile duct injuries (MBDI) and 54.3% as non-main bile duct injuries (NMBDI). Only 2.9% of cases involved vasculobiliary injury (VBI). Intraoperative diagnosis (Ei) occurred in 28.6% of cases, early postoperative diagnosis (Ep) in 62.9%, and late postoperative diagnosis (L) in 8.6%. LC was associated with 84.2% of NMBDI and 18.8% of MBDI, while OC was associated with 81.3% of MBDI and 15.8% of NMBDI. Clavien-Dindo classification showed 68.6% of cases in Class IIIb, 20% in Class I, 5.7% in Class V (mortality), 2.9% in Class IIIa, and 2.9% in Class IV. Early detection and management were associated with lower morbidity and mortality. Diagnostic laparoscopy was linked to lower morbidity and better outcomes. A proper reporting checklist is recommended to improve injury identification.
BDI remains a significant complication of cholecystectomy, with incidence ranging from 0.2 to 1.3%. The ATOM classification is now widely used to define BDI. Early diagnosis and management are crucial for better outcomes. Diagnostic laparoscopy is effective in identifying and managing BDI. Re-laparoscopy is useful for assessing and managing BDI, especially in minor cases. The study highlights the importance of early detection, proper classification, and appropriate management strategies. The use of the ATOM classification improved the accuracy of injury classification. The study also emphasizes the need for a standardized reporting system to enhance the identification and management of BDI. The results indicate that early diagnosis and management significantly reduce morbidity and mortality. The study concludes that further research is needed to develop a proper checklist for BDI reporting and to improve the management of BDI.