Cholescystectomy is probably the most commonly performed elective abdminal operation and major operation, should never be undertaken lightly.
Operative the duct injury have serious consequence in terms of morbidity and ultimate mortality. the life of the these patients is usually one of considerable distress unless correct treatment is instituted.
Almost all injury of bile duct occur during cholecystectomy. The exact incidence of bile duct injury is unknown, as many cases may go unreported in the literature. Kune and Sali suggested that the incidence of bile duct injury is about one in
300~500
gall stone operations.
A number of obvious factors have been associated with bile duct injury during cholecystectomy, including inadequate exposure and lighting, inexperience, and failure to identify structures before clamping ligating or dividing them. The usual error
is
that the common hepatic duct is mistaken for the cystic duct and it is excised with the gall bladder and in a number, the proximal common hepatic duct is also ligated.
Unfortunately, the injury is recognized at the original operation in only 12% to 46% of patients. If they are unrecognized or are managed improperly, life threatening complications such as biliary cirrhosis, portal hypertenson, and cholangitis
may
develop.
In almost all cases where an injury occurs and recognized, repair is best performed. At that time. Repair must be carried out in a precise and expert manner at eht first attempt, because repeated intervention is associated with less satisfactory
results.
We are discussed in 5 cases recognized bile duct injury during operation and 2 cases recognized bile duct jnjury after operation.
|