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

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 & PLUSMN; 103.2 min and 11.3 & PLUSMN; 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.

Automated summary

To reduce complications of gallbladder surgeries, an improved approach named transhepatic percutaneous cholangial drainage (TPCD) combined with end-to-end biliary anastomosis was introduced for bile duct injury repairment. Clinical data of 12 patients were retrospectively analyzed, showing successful repairment of all injuries without fatal cases. The mean operative time and hospital stay duration were 367.5 ± 103.2 min and 11.3 ± 3.5 days, respectively. Bile leakage occurred in two cases (16.7%) at the anastomosis site, while low-grade fever and postoperative infection of the incision site were observed in three patients (25.0%) and one patient (8.3%), respectively. No postoperative bleeding or bile duct strictures occurred. Follow-up results showed no cholangitis or bile duct restenosis.