Frequency of common bile duct injury in laparoscopic cholecystectomy

Abstract

Objective: The aim of the study is to review the frequency of Common BileDuct (CBD) injury in laparoscopic cholecystectomy (LC) and its managementin our set up.Methodology: This descriptive study was conducted at Surgical Department,Rawalpindi Medical College and the author's Surgical Clinics from January1998 to December 2012. Two thousand patients undergoing laparoscopiccholecystectomy were included in the study. The cases were operated betweenJanuary 1998 and December 2012. The important variables includedwere frequency of CBD injury and its management.Results: There were 1723 females and 277 males with mean age 45.04±11years. 67.8% patients had chronic cholecystitis with cholelithiasis and were admittedthrough Out Patient Department whereas 32.2% patients were admittedthrough A&E department. Abdominal ultrasound showed multiple calculiin 1535 (76.7%) patients and 435 (23.3%) patients had single calculus preoperatively.Empyema was found in 245(12.2%) cases whereas adhesions werepresent in 783(39.1%) patients. Conversion rate to open cholecystectomy was3.4 %. Seventeen cases had CBD injury (0.85%). 14 cases (82.3%) were diagnosedintraoperatively whereas 3 cases (17.7%) were diagnosed postoperatively.In 13 cases (76.5%) CBD repair was done over T.tube. Mean operatingtime was 30 minutes.Conclusion: The frequency of CBD injury in LC in our setup was less than 1%and is comparable to international experience. Most of the cases were diagnosedintraoperatively. Repair over T.tube is commonest method employedfor management of CBD injury with favorable results.