Minimally invasive treatment of patients with iatrogenic extrahepatic bile duct injuries after cholecystectomy
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16150Keywords:
laparoscopic cholecystectomy, extrahepatic bile ducts, diagnosis, treatment, endoscopic retrograde cholangiopancreatography, laparoscopy, complicationsAbstract
The aim of the work: to analyze the treatment outcomes of patients with extrahepatic bile duct injuries from 2019 to 2025.
Materials and Methods. A retrospective analysis was conducted on 63 patients with extrahepatic bile duct injuries who were hospitalized at the Municipal Non-Profit Enterprise “O. F. Herbachevskyi Regional Clinical Hospital” of the Zhytomyr Regional Council between 2019 and 2025. During the study period, 5,319 laparoscopic cholecystectomies were performed in the region, including 1,596 urgent and 3,723 elective procedures. The incidence of iatrogenic injuries was 1.18 %. All patients underwent comprehensive clinical and instrumental evaluation, including laboratory tests (complete blood count and biochemical blood analysis), abdominal ultrasound, magnetic resonance cholangiography (MRC), endoscopic retrograde cholangiopancreatography (ERCP), and contrast-enhanced computed tomography (CT). The type of injury was assessed according to the Strasberg classification. The timing of diagnosis, treatment modalities, complications, and length of hospital stay were analyzed.
Results. Minor injuries (Strasberg types A–D) were diagnosed in 79 % of patients, whereas type E injuries accounted for 21 %. Only 16 % of injuries were identified intraoperatively, while the remaining cases were diagnosed postoperatively. Early diagnosis (within 72 hours) was associated with fewer complications and a shorter hospital stay (mean 9.9 days), whereas delayed diagnosis (>72 hours) was associated with more severe complications and a longer hospitalization period (mean 11.9 days). Minimally invasive interventions proved to be the most effective treatment options in cases of early detection, particularly ERCP with biliary stenting and laparoscopic procedures.
Conclusions. Timely diagnosis and the implementation of an individualized treatment approach based on the type of injury and the patient’s general condition are key factors for successful management of extrahepatic bile duct injuries.
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