Immediate or Delayed Repair for Bile Duct Injury Recognized Postoperatively?

Abstract

Bile duct injuries occurring during laparoscopic cholecystectomy are rare, but result in considerable morbidity, rare mortality and major health care costs. Significant debate and controversy, however, remains regarding the optimal timing of repair of bile duct injury recognized in the postoperative period. Delayed bile duct injury repair has been associated with superior clinical outcomes when compared to immediate repair. Repair via a Roux-en-Y hepaticojejunostomy approach has been shown to have higher success rates when compared to direct repair of these injuries. Repair of bile duct injuries is feasible with no long-term physical quality of life impairments, but with deterioration in mental health that improves over time after repair.