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. 2023 Mar;51(3):3000605231162444.
doi: 10.1177/03000605231162444.

Outcomes of hepaticojejunostomy for post-cholecystectomy bile duct injury

Humaid Ahmad  1 , Haseeb Haider Zia  1 , Mohammad Salih  2 , Muhammad Naseer  2 , Nusrat Yar Khan  1 , Abu Bakar Hafeez Bhatti  1
Affiliations

Outcomes of hepaticojejunostomy for post-cholecystectomy bile duct injury

Humaid Ahmad et al. J Int Med Res. 2023 Mar.

Abstract

Objectives: Long-term results of hepaticojejunostomy (HJ) for complex bile duct injury (BDI) remain under-reported. The objective of this study was to assess short-term and long-term outcomes of HJ for post-cholecystectomy BDI.

Methods: This was a retrospective cohort study and included patients who underwent Roux-en-Y HJ for BDI (n = 87). Short-term (90-day) and long-term morbidity and mortality were assessed.

Results: At presentation, 42 (48.2%) patients had E3 or E4 BDI, 27 (31%) patients had vascular injury, and liver resection was performed in 12 (13.7%) patients. The 90-day morbidity was 51.7% (n = 45), and the 90-day mortality was 2.3% (n = 2). The long-term mortality was 3.4% (n = 3). The 10-year estimated stricture-free survival was 95%. The 10-year estimated overall survival rate was 100% in patients who underwent major hepatectomy and 91% in patients who did not. The 10-year estimated overall survival rate was 100% in patients with vasculobiliary injury and was not reached in patients without vascular injury.

Conclusions: Vascular injury with proximal BDI is not uncommon. Excellent long-term outcomes might be achieved with Roux-en-Y HJ for BDI with vascular injury and in patients requiring liver resection.

Keywords: Cholecystectomy; bile duct injury; hepatectomy; hepaticojejunostomy; liver resection; morbidity; mortality.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Estimated 10-year stricture-free survival in 44 patients with a minimum follow-up of 36 months. Cum, cumulative.
Figure 2.
Figure 2.
Estimated 10-year overall survival in patients undergoing repair of bile duct injury with or without hepatectomy. Cum, cumulative.
Figure 3.
Figure 3.
Estimated 10-year overall survival in patients undergoing repair of bile duct injury with or without vasculobiliary injury. Cum, cumulative.
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