Skip to main content
SpringerLink
Log in

Extrahepatic bile duct injury due to abdominal trauma

  • Case Reports of Interest
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

The diagnosis of bile duct injury due to abdominal trauma is usually not feasible preoperatively, but it must be suspected interoperatively with the presence of bile staining fluid in the subhepatic area. Four patients with bile duct injuries were encountered; these were the results of blunt injury in three and penetrating injury in one. The injury sites were in the common bile duct in two patients, and in the right hepatic duct just proximate to the bifurcation in two patients. One patient was diagnosed on the finding of bile stain discharged from the drainage tube after the first abdominal exploration. The other three patients were diagnosed by the amount of bile stained fluid collected in the subhepatic area during the primary laparotomy. The injuries of the common bile duct were treated by primary repairs and T-tube choledochostomy in two patients. The other two patients with right hepatic duct injuries were treated by right lobectomy because of extensive liver parenchyma injury. The postoperative courses were smooth and there were no deaths. We reviewed 27 reports (1984–1994) from around the world. The total operative mortality of the 75 patients in these reports was 18.67% (14/75) for the primary operation, and 7.14% (1/14) for re-operation in patients in whom reoperation was performed due to overlooked injuries or biliary complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kitahama A, Elliott LF, Overby JL, Webb WR (1982) The extrahepatic biliary tract injury. Ann Surg 196:536–540

    PubMed  Google Scholar 

  2. Shorthouse AJ, Snigh MP, Treasure T, Franklin R (1978) Isolated complete transection of the common bile duct by blunt abdominal trauma. Br J Surg 65:543–545

    PubMed  Google Scholar 

  3. Ivatury RR, Rohman M, Nallathambl M, Rao PM, Gunduz Y, Stabl WM (1985) The morbidity of injuries of the extrahepatic biliary system. J Trauma 25:967–973

    PubMed  Google Scholar 

  4. Felciano DV, Bitondo CG, Burch JM, Mattox KL, Beall AC Jr, Jordan GL Jr (1985) Management of traumatic injuries to the extrahepatic biliary ducts. Am J Surg 150:705–709

    PubMed  Google Scholar 

  5. Bade PG, Thomson SR, Hirshberg A, Robb JV (1989) Surgical options in traumatic injury to the extrahepatic biliary tract. Br J Surg 76:256–258

    PubMed  Google Scholar 

  6. Hill MW, Richardson AJ, Tait N, Deane SA, Little JM (1993) Noniatrogenic trauma to the extrahepatic biliary tract. Aust N Z J Surg 63:190–194

    PubMed  Google Scholar 

  7. Revuelta-Alvarez S, Lopez-Espadas F, Ortiz-de-Diego R, Fernandez-Escalante C (1993) Extrahepatic biliary lesions in abdominal traumatism. Rev Esp Enferm Apar Dig 84:249–252

    Google Scholar 

  8. Nikhinson RA, Chikhachev AM, Maslov SG, Aliev AD (1993) Blunt and penetrating injuries of gallbladder and extrahepatic bile ducts (in Russian). Klin Khir 3:21–23

    PubMed  Google Scholar 

  9. Kim PC, Gilas T, Brule MF (1993) Unusual isolated common bile duct injury after blunt trauma. Can J Surg 36:533–536

    PubMed  Google Scholar 

  10. Roche B, Menthas G, Gugmann P, La Scala G, Le Coultre C (1993) Intraheaptic biliary lesions following blunt liver trauma in children — is non-operative management or conservative operative treatment always safe? Eur J Pediatr Surg 3:209–212

    PubMed  Google Scholar 

  11. Moulton SL, Downey EC, Anderson DS, Lynch FP (1993) Blunt bile duct injuries in children. Ped Surg 28:795–797

    Google Scholar 

  12. Chung YC, Lee PH, Huang MT, Chang CN (1993) Complete transection of common bile duct due to blunt abdominal trauma; a case report and literature review. J Formos Med Assoc 92:78–81

    PubMed  Google Scholar 

  13. Burgess P, Fulton RL (1992) Gallbladder and extrahepatic biliary duct injury following abdominal trauma. Injury 23:413–414

    PubMed  Google Scholar 

  14. Dawson DL, Jurkovich GJ (1991) Hepatic duct disruption from blunt abdominal trauma; case report and literature review. J Trauma 31:1698–1702

    PubMed  Google Scholar 

  15. Thomson SR, Bade PG (1989) Penetrating bile duct trauma. Injury 20:215–216

    PubMed  Google Scholar 

  16. Bourque MD, Spigland N, Bensoussan AL, Garel L, Blanchard H (1989) Isolated complete transection of the common bile duct due to blunt trauma in a child, and review of the literature. J Pediatr Surg 24:1068–1070

    PubMed  Google Scholar 

  17. Chappuis JP, Cochet P, Takvorian P, Floret D (1987) Isolated rupture of the choledochus in closed injury of the abdomen in children. Chir Pediatr 28:325–328

    PubMed  Google Scholar 

  18. Rohatgi M, Grupta DK (1987) Isolated complete transection of common bile duct following blunt bicycle handlebar injury. J Pediatr Surg 22:1029–1030

    PubMed  Google Scholar 

  19. Mangiante EC, Brown L, Fabian TC (1987) Isolated blunt disruption of the common bile duct. J Tenn Med Assoc 80:483–484

    PubMed  Google Scholar 

  20. Janes KB, Thomas E (1985) Traumatic rupture of the hepatic duct demonstrated by endoscopic retrograde cholangiography 25:448–449

    Google Scholar 

  21. Lecklitner ML, Dittman W (1984) Postoperative evaluation of penetrating hepatic trauma and complication. J Nucl Med 25:982–983

    PubMed  Google Scholar 

  22. Drabble EH, Gani JS, Davidson P, Wright JE (1994) Partial laceration of the distal bile duct and wedge fracture of L1 caused by blunt trauma; a new perspective on treatment. Br J Surg 81:120

    PubMed  Google Scholar 

  23. Lehto M, Vilkki P (1985) Intraheperitoneal hepatic bile duct fistula following blunt abdominal contusion. Ann Chir Gynecol 74:296–298

    Google Scholar 

  24. Michelassi F, Ranson JH (1985) Bile duct disruption by blunt trauma. J Trauma 25:454–457

    PubMed  Google Scholar 

  25. Posner MC, Moore EE (1985) Extrahepatic biliary tract injury: Operative management plan. J Trauma 25:833–837

    PubMed  Google Scholar 

  26. Verran D, Schroeder D (1988) Management of intrahepatic bile duct injuries; presentation of two cases. Aust NZ J Surg 58:674–675

    Google Scholar 

  27. Salam M, Glowniak JV, Vetto RM (1987) Detection of bile leakage from traumatic right hepatic duct laceration with technetium-99m DISIDA cholescintigraphy. Clin Nucl Med 12:589–591

    PubMed  Google Scholar 

  28. Davids PHP, Tanka AKF, Rauws EAJ, van Gulik TM, van Leeuwen DJ, de Wit LTH, Verbeek PCM, Huibregtse K, van der Heyde MN, Tytgat GNY (1993) Benign biliary strictures: Surgery or endoscopy? Ann Surg 217:237–243

    PubMed  Google Scholar 

  29. Skow JR, Longmire WP Jr (1974) Common duct stricture secondary to blunt abdominal trauma. Am Surg 40:570–578

    Google Scholar 

  30. Fletcher WS (1972) Nonpenetrating trauma to the gallbladder and extrahepatic bile ducts. Surg Clin North Am 52:711–717

    PubMed  Google Scholar 

  31. Sugimoto K, Asari Y, Sakaguchi T, Owada T, Maekawa K (1993) Endoscopic retrograde cholangiography in the non-surgical mangement of blunt liver injury. J Trauma 35:192–199

    PubMed  Google Scholar 

  32. Colletti PM, Barakos JM, Ralls RE (1987) Hepatobiliary scintigraphy and scintiangiography in abdominal trauma. Clin Nucl Med 12:901–906

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of HBP Surgery, Department of Surgery, Kaohsiung Medical College Hospital, 80708, Kaohsiung, Taiwan

    Chen -Guo Ker

  2. Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan

    Tong -Kwang Yuan, Chung -Jou Yuan & Chung -Yin Yuan

Authors
  1. Chen -Guo Ker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tong -Kwang Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chung -Jou Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chung -Yin Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Ker, C.G., Yuan, T.K., Yuan, C.J. et al. Extrahepatic bile duct injury due to abdominal trauma. J Hep Bil Pancr Surg 3, 78–83 (1996). https://doi.org/10.1007/BF01212786

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01212786

Key words

Search

Navigation