A Three-Step Conceptual Roadmap for Avoiding Bile Duct Injury During Laparoscopic Cholecystectomy

Document Type : Original Article

Authors

General Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Laparoscopic cholecystectomy is among the most frequently conducted surgical procedures nowadays.
Aim: This investigation aimed to prevent bile duct injury during laparoscopic cholecystectomy.
Patients and methods: This was a prospective cohort research study that included 60 patients at the Department of Surgery in Al-Azhar University Hospitals, Cairo, Egypt.
Results: Regarding post-operative complications and outcomes among studied cases, the mean hospitalization length was 2.4±1.16 days with a range of 1-6 days. There were 18 (30%) with wound infection, 13 (21.7%) with subhepatic collection, 5 (8.3%) with retained stone, 14 (23.3%) with bile leak more than 50-100 mm/24 h, and 13 (21.7%) with bleeding from the abdominal cavity >100 mm/24 h, and mortality was reported in 1 (1.7%). There was a statistically significant correlation between preoperative difficulty with hospital length of stay, retained stone, and bile leak more than 50-100 mm/24 h, P < 0.05. Preoperative difficulty can predict intraoperative outcomes with 87.5% sensitivity, 80% specificity, and 81.6% accuracy. It can also predict conversion to open surgery with a sensitivity of 100%, specificity of 70%, and accuracy of 73.3%. It can also predict overall postoperative complications with a sensitivity of 59%, specificity of 80.5%, and accuracy of 70%.
Conclusion: We determined that difficulty before surgery predicts outcomes during surgery with an 87.5% sensitivity, 80% specificity, and 81.6% accuracy. It predicts the transition to open operations and the overall incidence of post-operative problems, with a 59% sensitivity, 80.5% specificity, and 70% accuracy.

Keywords

Al-Azhar International Medical Journal
Volume 2025, Issue 2
February 2025
Pages 123-128

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