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Outcome of reoperative surgery for late failure of postcholecystectomy bile duct injury repair

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Abstract

The aim of the study is to report the outcomes of reoperative surgery for late failure of postcholecystectomy bile duct injury (BDI) repair. All the patients, who underwent a reoperative surgery for late failure of postcholecystectomy BDI repair at our institution between August 2007 and July 2020, were retrospectively reviewed. Of the total 262 patients of BDI repair, 66 underwent reoperative surgery for late failure. Median duration between last attempt repair and the onset of recurrent symptoms was 18 months. Eighty-five percent of patients with failed repair became symptomatic within 5 years of attempt repair. The most common type of BDI was E3. All the patients underwent Roux-en-Y hepaticojejunostomy. Twenty-nine postoperative complications developed in 23 (35%) patients. Postoperative mortality was 1.5%. Median postoperative hospital stay was 9 (5–61) days. Over a median follow-up of 80 (12–150) months, 5.2% (3/58) of patients developed clinically relevant anastomotic stricture. Three patients with secondary biliary cirrhosis died in the follow-up period due to decompensated liver disease. Overall, excellent or good long-term outcome was achieved in 83% (48/58) of patients which was significantly less satisfactory than primary repair patients (82.8% vs 92.7%, p = 0.039). Reoperative surgery is safe in patients with failed repair after postcholecystectomy BDI and good long-term clinical success can be achieved in most of the patients. The long-term results were less satisfactory in failed-repair group than those who underwent primary repair at our institution. Early referral to a specialized unit for BDI repair may improve long-term outcome.

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Authors and Affiliations

  1. Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, West Bengal, 700020, India

    Sukanta Ray, Sujan Khamrui, Zuber Ansari, Arunesh Gupta, Suman Das & Jayanta Biswas

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  1. Sukanta Ray
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  2. Sujan Khamrui
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  3. Zuber Ansari
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  4. Arunesh Gupta
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Contributions

SR was involved in study design, writing, and drafting of the manuscript. SK, ZA, AG, SD, and JB were involved in the literature search, data collection, data analysis, and critical revision of the manuscript.

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Correspondence to Sukanta Ray.

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We declare that we have no competing interest regarding this manuscript and we do not have any financial support.

Human and animal rights

All the involved human participants were suffering from postcholecystectomy recurrent biliary stricture. Re-do surgery is an established treatment modality for this group of patients. They underwent surgery according to the protocol of our institution. Informed written consent was obtained from each patient prior to surgery.

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Informed consent was waived by our ethical committee because of retrospective nature of the study. All the procedures performed were part of routine care.

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Ray, S., Khamrui, S., Ansari, Z. et al. Outcome of reoperative surgery for late failure of postcholecystectomy bile duct injury repair. Updates Surg 74, 1543–1550 (2022). https://doi.org/10.1007/s13304-022-01325-2

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