Frequency of bile duct injuries according to the Parkland scale: study at Hospital Juárez de México

Background: Cholelithiasis affects 14.3% in Mexico.Cholecystectomy, mostly laparoscopic due to lower risks and quicker recovery, is the second most common surgery in Mexico.Bile duct injury rates have declined to 0.5-1.2% in the past decade.Objectives: Determine the frequency of bile duct disruption in patients with a Parkland Scale severity grade of 4 or 5 at Hospital Jurez de Mxico, during the period from 2018 to 2024.Methods: A cross-sectional, observational, and retrospective study analyzed medical records and surgical reports of patients with bile duct disruption at Hospital Jurez de Mxico.Results: From 2,167 cholecystectomies performed in 6 years, 329 (15.2%) were classified as Parkland 4. Of these, 329 (99%) did not experience bile duct disruption, while 5 (1%) did.In total, there were 5 cases of bile duct disruption occurring in-hospital and 18 referred from other centers.Conclusion: In 6 years, 329 difficult cholecystectomies (15.18%) were performed.Of the 6 cases with Parkland classification, 3 (0.138%) were secondary to open total cholecystectomy, 2 (0.092%) to laparoscopic total cholecystectomy, and 1 (0.046%) to open subtotal cholecystectomy.Disruptions were linked to higher Parkland classifications.The mortality rate was 17%, highlighting the need for skilled surgical management to improve outcomes.