World Journal of Surgery

, Volume 37, Issue 3, pp 573–581

Reoperative Surgery After Repair of Postcholecystectomy Bile Duct Injuries: Is it Worthwhile?

  • Pietro Addeo
  • Elie Oussoultzoglou
  • Pascal Fuchshuber
  • Edoardo Rosso
  • Cinzia Nobili
  • Regis Souche
  • Daniel Jaeck
  • Philippe Bachellier
Article

DOI: 10.1007/s00268-012-1847-y

Cite this article as:
Addeo, P., Oussoultzoglou, E., Fuchshuber, P. et al. World J Surg (2013) 37: 573. doi:10.1007/s00268-012-1847-y

Abstract

Background

Repeat repair of bile duct injuries (BDIs) after cholecystectomy is technically challenging, and its success remains uncertain. We retrospectively evaluated the short- and long-term outcomes of patients requiring reoperative surgery for BDI at a major referral center for hepatobiliary surgery.

Methods

Between January 1991 and May 2011, we performed surgical BDI repairs in 46 patients. Among them, 22 patients had undergone a previous surgical repair elsewhere (group 1), and 24 patients had no previous repair (group 2). We compared the early and late outcomes in the two groups.

Results

The patients in group 1 were younger (48.6 vs. 54.8 years, p = 0.0001) and were referred after a longer interval (>1 month) from BDI (72.7 vs. 41.7 %, p = 0.042). Intraoperative diagnosis of BDI (59.1 vs. 12.5 %, p = 0.001), ongoing cholangitis (45.4 vs. 12.5 %; p = 0.02), and delay of repair after referral to our institution (116 ± 34 days vs. 23 ± 9 days; p = 0.001) were significantly more frequent in group 1 than in group 2. No significant differences were found for postoperative mortality, morbidity, or length of stay between the groups. Patients with associated vascular injuries had a higher postoperative morbidity rate (p = 0.01) and associated hepatectomy rate (p = 0.045). After a mean follow-up of 96.6 ± 9.7 months (range 5–237.2 months, median 96 months), the rate of recurrent cholangitis (6.5 %) was comparable in the two groups.

Conclusions

This study demonstrates that short- and long-term outcomes after surgical repair of BDI are comparable regardless of whether the patient requires reoperative surgery for a failed primary repair. Associated vascular injuries increase postoperative morbidity and the need for liver resection.

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Pietro Addeo
    • 1
  • Elie Oussoultzoglou
    • 1
  • Pascal Fuchshuber
    • 2
  • Edoardo Rosso
    • 1
  • Cinzia Nobili
    • 1
  • Regis Souche
    • 1
  • Daniel Jaeck
    • 1
  • Philippe Bachellier
    • 1
  1. 1.Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la TransplantationHôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de StrasbourgStrasbourgFrance
  2. 2.Department of Surgical OncologyThe Permanente Medical GroupWalnut CreekUSA

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