Bile Duct Injury After Open Cholecystectomy: A Case Report

ABSTRACT: Cholecystectomy is one of the most frequently performed procedure in gastrointestinal surgery for calcular/acalcular and chronic/acute cholecystitis. The rate of clinically relevant bile leaks after conventional open cholecystectomy ranges from 0.1-0.5%. while biliary leakages have increased in the era of Laparoscopic surgeries up to 3%. Bile duct injuries (BDI’s) include cystic duct leakage, injuries to accessory ducts, common bile duct and vascular structure. The risk of BDI’s may be increased by aberrant, ignored or misidentified anatomy, difficult pathology, bleeding thermal injury, unexperienced and overconfident surgeons. We present a case of 26 years old female patient who visited surgery OPD, A. K. Tibbiya College & Hospital in surgery OPD, with complaints of post-operative biliary leakage, jaundice, fever (off & on) and pain in right hypochondrium for last 1 month. Cholecystectomy was conducted elsewhere. On abdominal examination, tenderness present with apparently positive icterus, and seropurulent discharge from surgical site. Drain was intact in situ and patient’s general condition was stable. Patient managed conservatively and symptomatically. After a month, she got relief in her symptoms, wound infection also subsides but bile leak continues. Then she successfully operated for hepaticojejunostomy under General Anesthesia (GA) in collaboration with surgical team of J. N. medical College & hospital, AMU. Patient again visited surgery OPD, AKTCH after successful procedure with no previous or any fresh complaints and improved her quality of life in every follow up