Resection of the gall-bladder is still the most common surgical procedure performed at general surgery departments. The laparoscopic method used in the majority of cases offers considerable benefits but at the same time is associated with an increased rate of bile duct complications. So far, a slim female aged 25-50 years was a typical patient with a iatrogenic bile duct injury.
The aim of the study was to identify the age of patients with iatrogenic bile duct injuries as well as the clinical course observed in recent years.
Material and methods. Gender and age structure of patients admitted to the Department of General, Transplant and Liver Surgery between the beginning of 2011 and June 2014 and treated for iatrogenic bile duct injuries, complications of laparoscopic cholecystectomy, were analysed. The patients were referred to the department as a reference centre.
Results. In the group of 186 patients, females predominated (69.4%) and the mean age was 52 years. A considerable increase in the mean age of patients treated in 2014 as compared with previous years was seen. This was related to an increased rate of bile duct injuries in patients aged over 70 years, who accounted for about 25% of the group. In previous years, bile duct injuries in patients of such an advanced age happened considerably less frequently.
Conclusions. A iatrogenic bile duct injury in an elderly person may prove a fatal complication. A repair surgery, i.e. the biliary-enteric anastomosis, is a major and burdensome procedure, particularly in the case of patients aged over 70 years. Special caution during laparoscopic cholecystectomy is advised in this population, and the slightest doubts should lead to conversion.
1. Andersson R, Eriksson K, Blind P-J et al.: Iatrogenic duct injury - a cost analysis. HPB 2008; 10: 416-19.
2. Moore DE , Feurer ID , Holzman MD et al.: Longterm detrimental affect of bile duct injury on health- related quality of life. Arch Surg 2004; 139: 476-82.
3. Stanowski E, Paczyński A, Koziarski T i wsp.: Powikłania cholecystektomii laparoskopowej - wyniki ankiety z 17 krajowych ośrodków chirurgicznych - 10 lat obserwacji. Pol Przegl Chir 2002; 74 (8): 691-99.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
SYNAT - “Interdisciplinary System for Interactive Scientific and Scientific-Technical Information”.