Our Summary

Bile duct injuries (BDIs) are a significant problem in liver and gallbladder surgery. They are mostly caused by medical procedures, particularly the removal of the gallbladder (cholecystectomy). Laparoscopic cholecystectomy, a minimally invasive procedure, is becoming more common, but it also increases the chance of BDI by 2-3 times compared to traditional open surgery. BDIs can also happen with robotic surgery.

In China, a professional medical group has published a guide on diagnosing and treating BDIs, with the goal of reducing the number of these injuries and improving their treatment. Surgery is the main method of treating BDIs and any narrowing of the bile ducts caused by injury. This surgery involves several steps, including exposing the upper and lower parts of the bile duct, preparing the tissue for joining, and joining the tissue in a minimally invasive way. These procedures are challenging and require a lot of skill and experience.

The researchers recommend using precision biliary surgery (surgery on the bile duct) to standardize the management of BDIs.

FAQs

  1. What are bile duct injuries and what causes them?
  2. How does laparoscopic cholecystectomy affect the chances of bile duct injuries?
  3. What are the steps involved in the surgery for treating bile duct injuries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about bile duct surgery is to follow all pre-operative instructions carefully, including fasting before the surgery and stopping certain medications as advised by the medical team. It is important to communicate openly with the surgical team about any concerns or questions you may have before the procedure. After surgery, it is important to follow all post-operative care instructions, such as taking prescribed medications, attending follow-up appointments, and avoiding heavy lifting or strenuous activity until cleared by the doctor. It is also important to monitor for any signs of infection or complications and report them to the medical team immediately. By following these guidelines, patients can help ensure a successful outcome from their bile duct surgery.

Suitable For

Patients who are typically recommended bile duct surgery include those with:

  1. Bile duct injuries caused by medical procedures such as gallbladder removal (cholecystectomy).
  2. Narrowing of the bile ducts due to injury.
  3. Complications from laparoscopic or robotic surgery.
  4. Patients with symptoms such as jaundice, abdominal pain, fever, or abnormal liver function tests.
  5. Those who have failed non-surgical treatments for bile duct issues.
  6. Patients with bile duct stones or strictures that cannot be treated through other methods.
  7. Those with bile duct cancer or other tumors affecting the bile ducts.

Timeline

Before bile duct surgery:

  1. Patient may experience symptoms such as abdominal pain, jaundice, fever, and itching.
  2. Patient undergoes diagnostic tests such as blood tests, imaging studies (CT scan, MRI, ultrasound), and endoscopic retrograde cholangiopancreatography (ERCP) to determine the extent of the injury.
  3. Patient may be prescribed medication to manage symptoms and prevent complications.

After bile duct surgery:

  1. Patient undergoes pre-operative preparation, including fasting and anesthesia consultation.
  2. Surgery is performed to repair the bile duct injury, which may involve laparoscopic or open surgery techniques.
  3. Patient is monitored closely in the post-operative period for complications such as infection, bleeding, or bile leakage.
  4. Patient may need to stay in the hospital for a few days to recover and receive further treatment.
  5. Patient undergoes follow-up appointments and imaging studies to monitor the healing process and ensure the success of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bile duct surgery?
  2. How experienced are you in performing bile duct surgery?
  3. What is the success rate of this surgery in treating bile duct injuries?
  4. How long is the recovery process expected to be after bile duct surgery?
  5. Are there any alternative treatments or procedures that could be considered for bile duct injuries?
  6. Will I need any additional imaging or tests before the surgery?
  7. How will the surgery affect my liver and gallbladder function?
  8. What type of anesthesia will be used during the surgery?
  9. How long will I need to stay in the hospital after the surgery?
  10. Will I need any follow-up appointments or care after the surgery?

Reference

Authors: Feng X, Dong J. Journal: Biosci Trends. 2017 Sep 12;11(4):399-405. doi: 10.5582/bst.2017.01176. Epub 2017 Aug 19. PMID: 28824026