Evaluation of different techniques for localization of biliary tract injury

ABSTRACT

The present study was designed to evaluate the results of different preoperative techniques for accurate localization of biliary tract injury. Thirty patients [21 females and 9 males] were included in this study. The clinical diagnosis was post operative bile duct injury. They presented mainly with jaundice, pain, dyspepsia, intermittent fever and other symptoms. Ultrasonography done to all patients, intrahepatic biliary radicle dilation, common bile duct dilatation and bile collection were evident findings. The accurate site of pathology was not clear in most of the cases. Percutaneous transhepatic [PTC] done for three patients with high serum bilirubin, after drainage PTC done. Intrahepatic biliary dilatation, proximal segment accurately localized. One patient developed biliary leakage. Retrograde cholangiopancreatography [ERCP] done for twenty patients, it clearly visualized the distal segment of the biliary tract. ERCP was helpful in diagnosis strictures. Failed cannulation occurred in five patients. Two patients developed cholangitis after ERCP. Magnetic resonance cholangiopancreatography [MRCP] done to ten patients. The findings was clear where proximal and distal segments were delineated as well as the intrahepatic dilated biliary radicles. From this study it was concluded that diagnosis of biliary tract injury could start with ultrasonography examination, followed by MRCP to localize the site of the pathology and the proximal segment before biliary reconstruction