Management of Bile Duct Injury Post Cholecystectomy in Al-Thawra General Modern Hospital (TMGH), Sana’a City, Yemen

Export Objective: Bile duct injuries (BDIs) following cholecystectomy remain a serious and potentially life-threatening complication, with severe consequences in some of patients. The purpose of this study was to evaluate the management of BDI post cholecystectomy among patients admitted to Al-Thawra General Modern Hospital with BDI during the period of this study. Methods: A prospective descriptive study on 21 patients with BDI post cholecystectomy referred to Al_Thawra Modern General Hospital between January 1, 2019 and February 28, 2023. The data were analyzed in terms of age, sex, type of previous operation, clinical picture, type of repair, and early postoperation complications. Results: The total number of 21 patients with BDI was included, with female preponderance 81% and with a median age of 30–39 years. Sixteen were having post open and five were post lap cholecystectomy. Obstructive jaundice was the most common clinical presentation (91%), followed by abdominal pain (57%). Regarding intraoperative, 18 patients were classified according to Strasberg as follows: one (4.76%) case was E1, eight (38%) cases were E2, seven (33.3%) cases were E3, and two (9.5%) cases were type D. Three cases were classified according to Bismuth classification class III. Roux-en-Y hepaticojejunostomy was performed in 18 cases, primary repair with t-tube in two cases, and choledochoduodenostomy in one case. Early complications were detected in five (23.8%) out of 21 patients in the form of bile leak from the surgically placed drain in two (9.5%) cases, intra-abdominal fluid collection (biloma) in one (4.76%) case, and surgical site infection was detected in two (9.5%) cases. Conclusion: Open cholecystectomy is still the most common cause of BDI in our country due to the lack of facilities in non-tertiary hospitals. Roux-en-Y hepaticojejunostomy reconstruction is performed in a tertiary hospital results in a good outcome.