Biliary tract injuries
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Hellenic Journal of Surgery (2015) 87:2, 149-155
Biliary Tract Injuries Poras Chaudhary, Rajeev Kumar, Mohinder P. Arora
Abstract Injury to the extrahepatic biliary tract occurs frequently due to damage inflicted during upper abdominal operations, cholecystectomy being the commonest situation followed by other upper abdominal surgeries, and less often due to blunt or penetrating abdominal injury. Most traumatic extrahepatic biliary tract injuries are caused by penetrating trauma and are usually discovered during laparotomy. Diagnosis is made by noting the accumulation of bile in the upper quadrant. The gallbladder is the most commonly injured structure. Regardless of the type of biliary injury and/or management, wide and adequate drainage is essential. Any upper abdominal operation can result in biliary tract injuries. Cholecystectomy is the procedure most implicated in biliary tract injuries because it is one of the most common elective surgeries performed worldwide. If not managed properly, bile duct injuries can lead to life-threatening complications. Identification and management of biliary tract injuries demand precise judgement, expertise, timely and appropriate intervention and prevention of complications. This study aims to present detailed information and an update on biliary tract injuries. Key words: Traumatic biliary tract injuries; iatrogenic biliary tract injuries; initial damage control drainage procedure; definitive reconstructive surgery
Introduction Injury to the extrahepatic biliary tract occurs frequently due to damage inflicted during upper abdominal operations, cholecystectomy being the commonest situation followed by other upper abdominal surgeries, and less often due to blunt or penetrating abdominal injury. Identification and management of biliary tract injuries demand precise judgement, expertise, timely and appropriate intervention and prevention of complications. Such injuries often require staged surgeries, i.e. drainage as an initial damage control procedure followed by definitive reconstructive surgery. If not managed properly, bile duct injuries can lead to life-threatening complications. This study aims to present detailed information and an update on biliary tract injuries. Traumatic biliary tract injuries
Extrahepatic biliary tract injuries are rare and can be caused by either penetrating or blunt trauma. Most extrahepatic biliary tract injuries are caused by penetrating trauma Poras Chaudhary, M.S., Associate Professor Surgery, Lady Hardinge Medical College, New Delhi, India Rajeev Kumar, M.S., Mohinder P Arora, M.S. Lady Hardinge Medical College, New Delhi, India Corresponding author: Poras Chaudhary Lady Hardinge medical college, New Delhi, India Tel.: 9891447358, e-mail: [email protected] Received 26 Nov 2014; Accepted 19 Dec 2014
Hellenic Journal of Surgery 87
and are usually discovered during laparotomy. Diagnosis is made by noting the accumulation of bile in the upper quadrant [1]. Zago et al. [2] concluded that a higher level of suspicion is necessary to ide
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