The long term effects on life quality followed by surgical treatments of iatrogenic biliary tract injuries

OBJECTIVE: Cholecystectomy is one of the operation has several complications and the most important one is iatrogenic bile duct injury. In this condition several reconstructive surgical procedures must be done. In this study, the long-term effects of reconstructive surgery on quality life of these patients was evaluated. MATERIAL AND METHOD: Fourty-nine patients (38 female,11 male) that underwent iatrogenic biliary tract injury during cholecystectomy.Reconstructive surgery between October 2009 and December 2017 were evaluated. The prospective outcomes of our retrospective operations on the long term quality life of patients were evaluated.General clinical status of patients, their biochemical tests and SF-36 survey were applied each patient and results were obtained. FINDINGS: Of the patients 32,6% were operated due to acute cholecystitis and 67,4 % due to chronic cholecystitis with gallstones. Biliary tract injuries were evaluated according to Strassberg classification, 7 patients had type A, 1 patient type C, 7 patients type D, 7 patients type E1, 12 patients type E3 and 3 patients type E4 injury. Roux-en-Y hepaticojejunostomy was performed in 30 patients, cystic duct/Luschka ligation in 6, primary common bile duct repair+ T-tube application in 5, endoscopic stent application in 4, in one patient cholangiojejunostomy, in one choleducholeducostomy andin one choleduchoduodenostomy. One of the patient who undergone cystic duct repair had vascular injury. Four patients excluded because of short follow up time.Bilirubin and transaminase and alkaline phosphatase levels significantly improved according to preoperative levels.When SF-36 survey results compared with Turkish norm values, significant improvement was seen. DISCUSSION AND RESULT: Ingeneral bile duct injury after cholecystectomy which is done in elective conditions, is an unexpected and a serious outcome. There is high morbidity and even mortality risks. Even if a successful operation is performed after this injury, it may cause a long-term decrease in both physical and mental quality of life. Words: Cholecystectomy, Biliary tract, SF-36