Laparoscopic bile duct injuries: timing of surgical repair does not influence success rate. A multivariate analysis of factors influencing surgical outcomes

Abstract Laparoscopic cholecystectomy (LC) is one of the most frequently performed surgical procedures worldwide. Iatrogenic bile duct injury (IBDI) is a serious complication of LC and has an incidence of 0.3 to 0.7%. Since it is associated with a significant and potentially lifelong morbidity as well as mortality, diagnosing IBDI as early as possible is of paramount importance. Management of bile duct injuries and prognosis of their surgical repair depend on the timing of its recognition, type and the extent of the injury. In this paper, we present a case of IBDI and attempt to discuss all its dimensions.

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Factors Influencing Surgical Outcomes in Orbital Trapdoor Fracture

10.21203/rs.3.rs-333415/v1 ◽

2021 ◽

Author(s):

Yi-Hua Chen ◽

Yueh-Ju Tsai ◽

I-Shiang Tseng

Keyword(s):

Multivariate Analysis ◽

Surgical Outcomes ◽

Roc Analysis ◽

Operating Characteristic ◽

Younger Patients ◽

Visual Outcomes ◽

Surgical Reduction ◽

Factors Influencing ◽

Significant Difference ◽

Special Subgroup

Abstract This study is aimed to determine the appropriate timing of performing surgical reduction on trapdoor fractures for bringing out better visual outcomes and the factors influencing surgical outcomes in this special subgroup of fracture victims. Data for 72 patients of orbital trapdoor fracture were analyzed retrospectively. Post- operative diplopia is the main posttreatment outcome of orbital bone fracture reduction. The receiver-operating characteristic (ROC) analysis indicated the cut-off point of surgical reduction timing at day 10 post-fracture. The rate of postoperative diplopia showed a significant difference between patients who underwent surgical reduction within 10 days and those who did after 10 days of injury (5.3% vs. 38.2%). Multivariate analysis revealed that preoperative infra-duction limitation (p=0.02), muscle incarceration (p=0.01), duration from injury to surgical reduction (p=0.004), and postoperative supra-duction limitation (p=0.004) were independent factors for poor surgical outcomes. In younger patients with head injury, the diagnosis of orbital trapdoor fracture should be kept in mind. Timely recognition and surgical reduction, especially within 10 days, can result in better visual outcomes without the occurrence of postoperative diplopia.

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Malignant Common Bile Duct Obstruction: Factors Influencing the Success Rate of Endoscopic Drainage

Endoscopy ◽

10.1055/s-2007-1012865 ◽

1990 ◽

Vol 22 (06) ◽

pp. 259-262 ◽

Cited By ~ 7

Author(s):

J. Boender ◽

G. A. J. J. Nix ◽

H. E. Schütte ◽

J. S. Laméris ◽

M. van Blankenstein ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Success Rate ◽

Bile Duct Obstruction ◽

Endoscopic Drainage ◽

Duct Obstruction ◽

Factors Influencing ◽

Common Bile Duct Obstruction

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Loss of patency after surgical repair of major laparoscopic cholecystectomy bile duct injuries: Contributing factors and long term outcomes

HPB ◽

10.1016/j.hpb.2020.04.363 ◽

2020 ◽

Vol 22 ◽

pp. S351-S352

Author(s):

J. Lindemann ◽

J. Krige ◽

U. Kotze ◽

M. Bernon ◽

S. Burmeister ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Surgical Repair ◽

Contributing Factors ◽

Long Term Outcomes ◽

Bile Duct Injuries

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Factors influencing surgical outcomes in orbital trapdoor fracture

Scientific Reports ◽

10.1038/s41598-021-96920-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yi-Hua Chen ◽

Yueh-Ju Tsai ◽

I-Shiang Tzeng

Keyword(s):

Multivariate Analysis ◽

Surgical Outcomes ◽

Roc Analysis ◽

Operating Characteristic ◽

Younger Patients ◽

Visual Outcomes ◽

Surgical Reduction ◽

Factors Influencing ◽

Significant Difference ◽

Special Subgroup

AbstractThis study is aimed to determine the appropriate timing of performing surgical reduction on trapdoor fractures for bringing out better visual outcomes and the factors influencing surgical outcomes in this special subgroup of fracture victims. Data for 72 patients of orbital trapdoor fracture were analyzed retrospectively. Post-operative diplopia is the main posttreatment outcome of orbital bone fracture reduction. The receiver-operating characteristic (ROC) analysis indicated the cut-off point of surgical reduction timing at day 10 post-fracture. The rate of postoperative diplopia showed a significant difference between patients who underwent surgical reduction within 10 days and those who did after 10 days of injury (5.3% vs. 38.2%). Multivariate analysis revealed that preoperative infra-duction limitation (p = 0.02), muscle incarceration (p = 0.01), duration from injury to surgical reduction (p = 0.004), and postoperative supra-duction limitation (p = 0.004) were independent factors for poor surgical outcomes. In younger patients with head injury, the diagnosis of orbital trapdoor fracture should be kept in mind. Timely recognition and surgical reduction, especially within 10 days, can result in better visual outcomes without the occurrence of postoperative diplopia.

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Surgical Management of Complex Bile Duct Injuries in Specialized Hepatopancreatobiliary (HPB) Unit

10.53350/pjmhs211571700 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1700-1702

Author(s):

Muhammad Khawar Shahzad ◽

Tariq Ali Bangash ◽

Amer Latif ◽

Hussam Ahmed ◽

Muhammad Asif Naveed ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Retrospective Study ◽

Bile Duct ◽

Hospital Stay ◽

Surgical Management ◽

Bile Duct Injury ◽

Surgical Repair ◽

Open Cholecystectomy ◽

Tube Placement ◽

Bile Duct Injuries

Objective: To describe the surgical management of complex bile duct injuries in a specialized hepatopancreatobiliary unit. Design of the Study: It was a retrospective study. Study Settings: This study was carried out at Department of Anaesthesia and Hepatobiliary Unit, Sheikh Zayed Hospital Lahore from August 2017 to August 2019. Material and Methods: This retrospective study includes 80 patients of bile duct injury who underwent surgical correction of bile duct injury at specialized Hepatopancreatobiliary [HPB] and liver transplant department of Shaikh Zayed Hospital Lahore. All the subjects were evaluated by retrospectively. The information regarding primary operative procedure, drain placement, T-tube placement, presentation, hospital stay, Liver Function Tests [LFTs], level of biliary tract injury and type of surgical procedure obtained from patients records. Results of the Study: During the study period 80 patients – 65 females and 15 male were operated for bile duct injury. Mean age was 39.89 years range 21 to 65 years. Hospital stay ranges from 9 to 36 days with mean of 16.18 days. Patients underwent open cholecystectomy, 43.8% laparoscopic cholecystectomy and in 3 patients procedure was converted from laparoscopic to open. 52.5% patients underwent open cholecystectomy, 43.8 laparoscopic cholecystectomy and in 3 patient’s procedure was converted from laparoscopic to open. Conclusion: It is concluded that the correct long lasting and physiological method to treat injuries of bile duct is only surgical repair. Although, surgical repair of bile duct must be operated by skilled hepatopancreaticobiliary surgeons. A practical method which is selected appropriately and implemented successfully has surely improved surgical outcome without any problem faced during the operation. Keywords: Hepatopancreatobiliary, Bile Duct Injury, Surgical Management

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