RT Journal Article
SR Electronic
T1 Bile duct injury: to err is human; to refer is divine
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e228361
DO 10.1136/bcr-2018-228361
VO 12
IS 4
A1 Saket Kumar
A1 Pavan Kumar
A1 Abhijit Chandra
YR 2019
UL http://casereports.bmj.com/content/12/4/e228361.abstract
AB A 42-year-old woman sustained complete transection of common hepatic duct during routine laparoscopic cholecystectomy. The surgery was being performed at a rural setting, and the injury was identified intraoperatively. The surgeon sought the opinion of an expert biliary surgeon via telephone and discussed the possibility of an immediate end-to-end bile duct repair. Since he lacked the experience of doing biliary-enteric anastomosis, he was advised to place a subhepatic drain and transfer the patient to the hepatobiliary centre for definitive surgery. At the referral centre, the patient was evaluated and planned an immediate biliary repair. On exploration, she was found to have a major type, Strasberg E5 injury. The transected ducts were small in calibre and required double Roux-en-Y hepaticojejunostomy over transanastomotic stents. The postoperative recovery was uneventful. Transanastomotic stents were removed after 6 months, and the patient remained perfectly well at a follow-up of 1 year.