ABSTRACT
Background: The term of postcholecystectomy syndrome [PCS] comprises a heterogeneous group of symptoms and signs in patients who have previously undergone cholecystectomy. Patients of PCS may present with abdominal pain, jaundice or dyspeptic symptoms, man y of these complaints can he attributed to complications including bile duct injury, biliary leak, biliary fistula and retained stones. Late sequelae are bile duct strictures and secondary liver cirrhosis. A multidisciplinary approach between surgeons, radiologist and endoscopist offers the best chances for an initial diagnosis and therapeutic option
The aim of this work: Is to study thoroughly and evaluate the different techniques, surgery endoscopy and combined used for management of postcholecystectomy problems
Patients and methods: This is a descriptive study carried on 105 patients from the surgery department, and endoscopy unit of Assuit University Hospital from January 2010 - to July 2012
Results: Most of our patients [97.1%] diagnosed in postoperative period and only 2.9% of injuries are recognized intraopertively. Sixty eight of 105 [64.7%] of patients has bile leakage, retaned stones and stricture was treated endoscopically. The remaining [35.3%] were treated surgically. Long-term follow-up revealed two cases [5.4%] with anastomatic stricture, which were managed by refashioning HJ with left ductal approach
Conclusion: [I] Minor bile duct injuries can be well treated by endoscopic techniques. [II] Mayor injuries of bile ducts require operative intervention alter good and adequate preparation, [III] Raux-en-YHJ is the gold standard operation for these major bile duct injuries