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Optimizing surgical management of iatrogenic bile duct injury: transhepatic percutaneous cholangial drainage combined with end-to-end biliary anastomosis

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Abstract

Iatrogenic bile duct injury remains the most severe complication of gallbladder surgeries. To reduce post-operation complication, we introduce an improved approach for bile duct injury repairment, named transhepatic percutaneous cholangial drainage (TPCD) which combined with end-to-end biliary anastomosis. Clinical data obtained from 12 patients between February 2012 and May 2022 were retrospectively analyzed. Patient demographic, clinical, operative, and follow-up data were analyzed using descriptive statistics. All injuries were repaired successfully and no fatal cases occurred. The mean operative time and hospital stay duration were 367.5 ± 103.2 min and 11.3 ± 3.5 days, respectively. In two cases (16.7%), bile leakage occurred at the bile duct anastomosis site. Three patients (25.0%) developed low-grade fever and one patient (8.3%) developed a postoperative infection of the incision site. No postoperative bleeding or bile duct strictures occurred in any of the cases. The patients were followed up from 12 to 122 months (median, 70.5 months). No cholangitis or bile duct restenosis was observed after biliary drainage tube removal. There were no long-term bile duct-related complications seen in the follow-up time. It is safe and feasible for TPCD combined with end-to-end biliary anastomosis using in bile duct injury.

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Data Availability

All data generated or analysed during this study are included in this published article.

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Acknowledgements

We really appreciate the Elsevier Language Editing Service institution for providing language help with our manuscript.

Funding

The research was supported by Health Commission of Zhejiang Province (JBZX-202004).

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Authors and Affiliations

  1. Department of Hepatopancreatobiliary Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China

    Ling Liu, Chenjie Yao, Xinyu Chen, Hongwei Chen, Weimin Shen & Changku Jia

  2. Department of Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China

    Changku Jia

Authors
  1. Ling Liu
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  2. Chenjie Yao
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  3. Xinyu Chen
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  4. Hongwei Chen
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  5. Weimin Shen
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  6. Changku Jia
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Contributions

Conception and the design of the study: LL, and JCK. Acquisition of data: YCJ, CXY, CHW, and SWM. Analysis and interpretation of data: LL and YCJ. Draft and critical analysis: LL, YCJ, and CXY.

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Correspondence to Changku Jia.

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The authors have no conflicts of interest to declare.

Ethics approval and consent to participate

This study protocol was reviewed and approved by the Ethics Committee of Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine (Reference No. IIT-20211228-0151-01). In addition, written informed consent was obtained from all participants.

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Research involving human participants and/or animals. This article does not contain any studies with animals performed by any of the authors.

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Liu, L., Yao, C., Chen, X. et al. Optimizing surgical management of iatrogenic bile duct injury: transhepatic percutaneous cholangial drainage combined with end-to-end biliary anastomosis. Updates Surg 75, 1911–1917 (2023). https://doi.org/10.1007/s13304-023-01565-w

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  • DOI: https://doi.org/10.1007/s13304-023-01565-w

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