Mohammad Zarin, Mujeebur Rehman, Shehzad Akbar, Usra Ahmed, Mansoor Khan, Roohul Muqim, Aziz Wazir, Muhammad Salman.
Bile duct injury in laparoscopic cholecystectomy without on table cholangiography.
Pak J Surg Jan ;26(2):104-7.

Objective: To determine the safety of laparoscopic cholecystectomy without on table cholangiography. Study Design: Quasi- experimental study Setting and Duration: Surgical “D” ward Khyber teaching hospital Peshawar from January 2005 to December 2008. Methodology: Patients of acute or chronic cholecystitis due to gall stones were included in this study while patients of obstructive jaundice and gall bladder mass were excluded. All patients were operated through laparoscopic cholecystectomy without on table cholangiography. During procedure bile duct injury were noted and evidences of bile duct injury were also collected post operatively during hospitalization and follow up visits. Data regarding complications in terms of bile duct injury were recorded and analyzed. Results: A total of 7 (0.92%) bile duct injuries were noted in this series. Th ere were two (0.26%) cases of partial injury to the common hepatic duct out of which 1 was a case of Mirizzi’s syndrome. In the second case a partial injury to the common hepatic duct occurred during an att empt to cauterize the avulse branch of cystic artery. In two (0.26%) patient’s partial injury to common bile duct occurred due to tenting of common bile duct. Complete transaction of Common bile duct occurred in two (0.26%) cases. In one (0.13%) patient post operative leakage was found to be due to severed cholecystohepatic duct. Conclusion: This study concludes that absence of OTC facility does not lead to alarmingly increased rate of bile duct injuries during laparoscopic cholecystectomies.

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