Evaluation of Factors Affecting Mortality in 35 Biliary Tree Injury Cases

INTRODUCTION: Cholecystectomy is one of the most common operations performed by general surgeons. With the increase in surgeons' skills and advances in technology, laparoscopic cholecystectomy has become the gold standard. However, laparoscopic approach carries a higher risk for biliary tree injury. In this study, it was aimed to perform clinical analyzes of patients operated on for biliary tree injury and to evaluate the treatment results and mortality factors.
METHODS: Patients who were operated for bile duct injuries between 1994 and 2018 at XXX were selected for the study retrospectively. The data of the patients were collected and the factors determining mortality were evaluated using the Mann-Whitney U test, Chi-Square test and Fisher Exact Test, assuming p = 0.05.
RESULTS: Among 35 patients included in this study, 25 were female (71.4%). The mean age of patients was 45.1 years (22-75). In the etiology, gall bladder operations (n=29, 82.8%) performed for cholecystolithiasis was the most common. According to the Bismuth-Strasberg classification, while isolated E type injury was seen in 22 patients (62.9%), isolated D type injury was seen in 10 patients (28.6%). The most performed surgery was hepaticojejunostomy (48.5%). Gender, age, first surgery etiology and indication, the day between first surgery and reconstructive surgery, type of injury, type of reconstructive surgery, and hospital stay did not affect mortality (p>0.05).
DISCUSSION AND CONCLUSION: Biliary tree injury is a life-threatening complication of cholecystectomy and should be managed with a multidisciplinary approach. Although no factor affecting mortality was found in this study; late diagnosis and treatment increases both morbidity and mortality.