Frequency of common bile duct injury in laparoscopic cholecystectomy

ABSTRACT

The aim of the study is to review the frequency of Common Bile Duct [CBD] injury in laparoscopic cholecystectomy [LC] and its management in our set up. This descriptive study was conducted at Surgical Department, Rawalpindi Medical College and the author's Surgical Clinics from January1998 to December 2012. Two thousand patients undergoing laparoscopic cholecystectomy were included in the study. The cases were operated between January 1998 and December 2012. The important variables included were frequency of CBD injury and its management. There were 1723 females and 277 males with mean age 45.04 +/- 11years. 67.8% patients had chronic cholecystitis with cholelithiasis and were admitted through Out Patient Department whereas 32.2% patients were admitted through A and E department. Abdominal ultrasound showed multiple calculi in 1535 [76.7%] patients and 435 [23.3%] patients had single calculus preoperatively. Empyema was found in 245[12.2%] cases whereas adhesions were present in 783[39.1%] patients. Conversion rate to open cholecystectomy was3.4 %. Seventeen cases had CBD injury [0.85%]. 14 cases [82.3%] were diagnosed in traoperatively whereas 3 cases [17.7%] were diagnosed postoperatively. In 13 cases [76.5%] CBD repair was done over T. tube. Mean operating time was 30 minutes. The frequency of CBD injury in LC in our setup was less than 1%and is comparable to international experience. Most of the cases were diagnosed in traoperatively. Repair over T. tube is commonest method employed for management of CBD injury with favorable results: