Clinical analysis of diagnosis and treatment in patients with bile duct injuries associated with laparoscopic cholecystectomy
10.3760/cma.j.cn113884-20241205-00365
- VernacularTitle:腹腔镜胆囊切除术相关胆管损伤患者的临床诊治分析
- Author:
Xiaobo WANG
1
;
Hui ZHAO
1
Author Information
1. 楚雄彝族自治州人民医院肝胆外科，楚雄 675000
- Publication Type:Journal Article
- Keywords:
Bile ducts;
Injury;
Repair;
Hepaticojejunostomy;
Stricture
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(6):443-446
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore optimal timing and surgical approaches for bile duct repair in patients with bile duct injuries associated with laparoscopic cholecystectomy (LC-BDI).Methods:A retrospective analysis was conducted on the clinical data of 13 patients with LC-BDI treated at Chuxiong Yi Autonomous Prefecture People's Hospital from October 2012 to October 2023. The cohort included 6 males and 7 females, aged (51.2±7.6) years. Clinical parameters such as gender, age, Strasberg classification, timing of surgery, surgical techniques, and complications were recorded. Postoperative follow-up was conducted via telephone to assess complications and reoperation status.Results:Among the 13 LC-BDI patients, 4 cases were diagnosed intraoperatively during LC, while 9 cases were diagnosed postoperatively. The Strasberg classification was as follows: 5 cases of E2, 6 cases of E3, and 2 cases of E4. Except for 2 patients who underwent immediate repair during LC, the remaining 11 patients initially received proximal bile duct or subhepatic space drainage, followed by definitive biliary reconstruction after 6-8 weeks. All 13 patients underwent repair via side-to-side hepaticojejunostomy (SSHJ). Over a mean follow-up period of (68.5±30.8) months, only 1 patient with Strasberg E4 LC-BDI was judged as repair failure at 21 months postoperatively; the remaining 12 cases achieved successful repair.Conclusion:For LC-BDI patients with Strasberg E2 or higher classifications, in the absence of intra-abdominal infection, biliary reconstruction via SSHJ at 6-8 weeks postoperatively demonstrated superior therapeutic efficacy.
