Surgical Treatment Results And Analysis Of20Cases With Biliary Injury During Laparoscopic Cholecystectomy

Objective:To summarize the experience in biliary injury during laparoscopic cholecystectomy and investigate the prognostic factors of biliary injury during laparoscopic cholecystectomy.Methods:We collected and retrospectively analyzed the clinical data of20patients who suffered from biliary injury during laparoscopic cholecystectomy which were treated by experienced hepatobiliary surgeons. Descriptive statistics were used to analyze the data including gender, age, initial symptoms, indication for LC, associated vascular injury, hospital stay, site of injury, classification, surgery methods.Results:There were20cases totally in this article which including6males and14females aged from23to71years old. From these20cases,19were treated through surgery way, including2cases of derect suture,6cases of end-to-end anastomosis,11cases of hepaticojejunostomy. Of these20cases,3were diagnosed during surgery, other17were diagnosed after surgery but before discharged from hospital. All the surgery were operated by experienced hepatobiliary surgeons. Only1case was accompanied by vascular injury. All the patients had no obvious symptoms of recurrent cholangitis. All the patients survived from the surgery except1was lost in the follow-up. The average hospital stay was14±3.8days. The average follow-up was14.4±9.4months. There were7cases of stenosis after reconstruction, of which4were under hepaticojejunostomy,2were under end-to-end anastomosis,1was under derect suture.Conclusion:The biliary injury during laparoscopic cholecystectomy should operated by experienced hepatobiliary surgeons, the surgeons should know biliary anatomy, and dissected the Calot area carefully. Introperative cholangiography should be performed if necessary. Once biliary injury happens, the reconstruction should be performed as soon as possible. The best surgery method was hepaticojejunostomy.