XXXX to Repair: an Analysis of Management and Outcome.

@entity1 @entity295 @entity82 @entity101 @entity548 @entity1157 @entity3116 @entity298
Despite advances in speciality care, mortality and morbidity remain the most important issues in the management of post-cholecystectomy bile duct injuries. We analysed the peri-operative management of post-cholecystectomy bile duct injuries to assess their outcomes. Of 150 @entity1 with post-cholecystectomy bile duct injuries, 13 @entity1 who presented with strictured hepaticojejunostomy were excluded from the analysis. The records of the remaining 137 @entity1 were analysed for type of presentation, management and follow-up. Of 137 injuries, 88 were open and 49 were laparoscopic. Various presentations include acute @entity1157 (n   =   5), bile collection (n   =   45), external @entity3116 (n   =   46) and stricture (n   =   41). After initial management, three @entity1 died ( @entity295 , n   =   2; @entity548 , n   =   1). Of 107 @entity1 who underwent definitive repair, three died (portal @entity101 , n   =   2; @entity295 , n   =   1). At median follow-up of 30  months, 100 @entity1 had good outcome (grade A, B), and only 4 had bad outcome (grade C, D) as per McDonald grading. @entity298 and @entity295 in the early phase and portal @entity101 and @entity82 in the late phase are the main causes of mortality in @entity1 sustaining @entity1157 during cholecystectomy. Successful management in a specialist hepatobiliary centre can limit the morbidity in more than 90  % cases.
