AB094. SOH25_AB_221. Surgical management of iatrogenic bile duct injuries: a multi-centre retrospective review
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AB094. SOH25_AB_221. Surgical management of iatrogenic bile duct injuries: a multi-centre retrospective review

Conor Mullen1, Jamie Walsh2, Robert O’Connell1, Niall Hardy2, John Conneelly2, Gerry McEntee2, Anthony Stafford1, Fiona Hand1, Tom Gallagher1, Emir Hoti1

1Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland; 2Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland

Background: Iatrogenic bile duct injuries (IBDIs) are a rare but potentially dramatic complication of laparoscopic cholecystectomy. Surgical management is challenging with significant morbidity and impact to patients’ quality of life. The aim of this study was to present the current surgical management strategies of IBDIs across two hepatobiliary (HPB) centres in Ireland and to evaluate the perioperative and long term outcomes.

Methods: Between 2014 and 2024, a retrospective multi-centre study was conducted. Patients who underwent operative management of iatrogenic bile duct injuries post laparoscopic cholecystectomy were identified in two HPB centres.

Results: There were 24 patients who underwent surgical management for IBDIs. Nineteen patients had Roux-En-Y hepaticojejunostomy. Three patients required right hepatectomy and hepaticojejunostomy. Two patients had a primary repair over a T tube. The median time to definitive surgical management post injury was 8 days. Eight (33.4%) patients had an associated vascular injury. Post-operative morbidity was 54.2%. Three (12.5%) patients required re-laparotomy, one patient eventually required orthotropic liver transplant (OLT) and there were 3 (12.5%) perioperative mortalities. There was no association between time of detection or vascular injury and Clavien-Dindo classification. Five patients developed biliary strictures with 3 (12.5%) patients requiring revision hepaticojejunostomy.

Conclusions: Iatrogenic bile duct injuries pose a considerable risk of long term complications and mortality requiring multi-disciplinary team management in a tertiary HPB centre. Early identification of bile duct injuries, in addition to a precise description of the injury can expedite surgical management and improve perioperative and long term outcomes.

Keywords: Bile duct injury; hepaticojejunostomy; laparoscopic cholecystectomy; post-operative complications

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab094
Cite this abstract as: Mullen C, Walsh J, O’Connell R, Hardy N, Conneelly J, McEntee G, Stafford A, Hand F, Gallagher T, Hoti E. AB094. SOH25_AB_221. Surgical management of iatrogenic bile duct injuries: a multi-centre retrospective review. Mesentery Peritoneum 2025;9:AB094.

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