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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2015, Vol. 9 Issue (4) : 508-511    https://doi.org/10.1007/s11684-015-0418-7
COMMENTARY
Bile duct injury repair — earlier is not better
Vinay K. Kapoor()
Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
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Abstract

Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.

Keywords bile duct injury      cholecystectomy      laparoscopic cholecystectomy     
Corresponding Author(s): Vinay K. Kapoor   
Just Accepted Date: 16 September 2015   Online First Date: 13 October 2015    Issue Date: 26 November 2015
 Cite this article:   
Vinay K. Kapoor. Bile duct injury repair — earlier is not better[J]. Front. Med., 2015, 9(4): 508-511.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-015-0418-7
https://academic.hep.com.cn/fmd/EN/Y2015/V9/I4/508
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