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28115

Management of Postcholecystectomy Obstructive Jaundice

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Last updated: 30 Jan 2023

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Abstract

Background: Although laparoscopic cholecystectomy (LC) has many unquestionable advantages, this type of surgery has a higher incidence of complications than those of open cholecystectomy including biliary tract injury or stricture causing hyperbillirubinaemia and jaundice and subsequently a lot of complications as acute peritonitis or acute cholangitis as well as complications of jaundice that may be so severe causing hepatorenal failure. Objective: To find the proper method of management of postcholecystectomy obstructive jaundice. Patients and Methods: A retrospective study of 20 patients who were presented with postcholecystectomy obstructive jaundice within 2 years from the date of surgery were selected for this study. Patients were subclassified according to the cause of postcholecystectomy jaundice into 4 groups: Group A: patients presented with jaundice due to missed common bile duct (CBD) stones. Group B: patients presented with jaundice due to biliary injury. Group C: patients presented with jaundice due to biliary stricture. Group D: patients presented with jaundice due to medical causes. Results: ERCP should only be attempted when there is biliary contiuity evident by MRCP. Roux en Y hepaticojejunostomy is the most used modality in management. The best treatment of post-cholecystectomy obstructive jaundice is undoubtedly prevention of bile duct injury during cholecystectomy. Conclusion: The classic pattern of laparoscopic injury appears to be misidentification of the common duct for the cystic duct, resection of a portion of the common and hepatic ducts, and an associated right hepatic arterial injury.

DOI

10.21608/ejhm.2019.28115

Keywords

Cholecystectomy, Obstructive jaundice, bismuth classification

Authors

First Name

Mohammad Mohsen

Last Name

Salem

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Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

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First Name

Yasser Hussein

Last Name

Hassan

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Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Abdou Ibrahim

Last Name

Zeyada

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Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

Email

abdozyada42@gmail.com

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Volume

74

Article Issue

7

Related Issue

4924

Issue Date

2019-01-01

Receive Date

2019-02-27

Publish Date

2019-01-01

Page Start

1,566

Page End

1,576

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_28115.html

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https://ejhm.journals.ekb.eg/service?article_code=28115

Order

14

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

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Article

Created At

22 Jan 2023