Saudi Journal of Gastroenterology

ARTICLES
Year
: 2004  |  Volume : 10  |  Issue : 1  |  Page : 8--15

Management of postlaparoscopic cholecystectomy major bile duct injury: Comparison of MRCP with conventional methods


Khalid Mohammad Abou El-Ella1, Osama Nafea Mohamed1, Mohamed Ibrahim El-Sebayel1, Saleh Ali Al-Semayer2, Ibrahim Abdulkarim Al Mofleh3 
1 Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia
2 Department of Radiology, King Khalid University Hospital, Riyadh, Saudi Arabia
3 Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia

Correspondence Address:
Osama Nafea Mohamed
Department of Surgery, King Khalid University Hospital, P. O. Box 7805, Riyadh 11472
Saudi Arabia

Background: Postlaparoscopic cholecystectomy bile duct injury remains one of the devastating complications seen in current surgical practice. Aim of Study: This study describes the diagnostic role of magnetic resonance cholangiopancreatography (MRCP) in such injuries compared with conventional methods. Patients and Methods: Eighteen patients referred to the Division of Hepatobiliary Surgery, King Khalid University Hospital from July 1998 to September 2000 were retrospectively studied. The technique of the repair was by utilizing Roux-en-Y hepaticojejunostomy with establishment of mucosa-to-mucosa anastomosis.The study included presentation, age and gender. Results: The presentation of patients were variable and frequently included pain, jaundice with or without cholangitis in 13 patients, bile leakage with development of biliary peritonitis in three, and development of external biliary fistula in two patients. Besides lower incidence of complication, MRCP was more diagnostic and informative in planning surgery by mapping both ducts proximal and distal to site of injury or stricture in 14 out of 18 patients. The Bismuth level of bile duct injuries were type I in one, type 11 in five, type III in 11 and type IV in one patient. All patients are alive, well and no complications occurred in the immediate postoperative period. Only two patients developed stricture within four months after surgery, one of them treated conservatively with repeated dilatation and stenting was done for the other. Conclusion: Hepaticojejunostomy is the procedure of choice for repair of bile duct injuries and provides adequate bilairy drainage. MRCP is an ideal diagnostic test when bile duct injury is suspected following laparoscopic cholecystectomy


How to cite this article:
Abou El-Ella KM, Mohamed ON, El-Sebayel MI, Al-Semayer SA, Al Mofleh IA. Management of postlaparoscopic cholecystectomy major bile duct injury: Comparison of MRCP with conventional methods.Saudi J Gastroenterol 2004;10:8-15


How to cite this URL:
Abou El-Ella KM, Mohamed ON, El-Sebayel MI, Al-Semayer SA, Al Mofleh IA. Management of postlaparoscopic cholecystectomy major bile duct injury: Comparison of MRCP with conventional methods. Saudi J Gastroenterol [serial online] 2004 [cited 2021 Apr 11 ];10:8-15
Available from: https://www.saudijgastro.com/article.asp?issn=1319-3767;year=2004;volume=10;issue=1;spage=8;epage=15;aulast=Abou;type=0