Attached
Introduction
The incidence o f iatrogenic bile d u ct Injuries (IB D I) has
ch an ge d in th e recent past. In Sri Lanka th e current
gen eration o f su rge o n s have had form al training in
lap aroscopy ch olecystectom y (LC) co m p are d to th o se in
the introductory period, w e analyzed the patterns o f
IB D I detected d u rin g ERC d u rin g tw o tim e pe riods (2003-
2 0 1 0 an d 2011 to date) for a n y significant differences in
injury patterns.
M ethods
Retrospective analysis o f th e ERC fin d ings o f patients
'w ith IBD I from 2003 to 2016 w as d o n e in a tertiary care
unit. Injuries w ere categorized by B ism uth -Strasb e rg
d assification(A -E). E( 1-5) w ere considered as m ajor
injuries.
Results
O v e r 13 years, 87 patients w ith IB D I w ere referred *:r
ERC. M a jo rity (8 0 % ) w ere fem ales. M e a n age w as
years (range 17-81). In the early period (2003-2211
o n ly 5 5 % o f injuries w ere due to LC, w hile 7 7 % v.e~
w ith LC in the latter period (p=0.02). In the early pe r :-z
6 7 % w ere m ajor injuries (B ism uth E 1-5) w hile -~ -
w ere m ajor in th e post-2 0 1 0 gro u p (p=0.047; : *
univariate analysis. H ow e ve r in am ultifacto rial anai .s
there w a s no difference in the injury severity b ase c :*
t h e t im e p e r io d ( p = 0 . 0 6 8 ) o r t h e t y p e :
siirgefy(p=0.271). C onve rsion rates to open surge*
a n d th e fr a c t io n o f in ju rie s n e e d in g s u r g is s
reconstruction w ere n o t significantly different betwee *
periods.
Conclusion
The prop ortion o f IBD I d u e to LC, co m pare d to ope *
surgery has risen significantly. Form al training in _1
ap p e ars not to have affected the severity o f IB I
conversion rate o r th e percentage o f patients re q u ire j
surgical reconstruction . The stu d y is lim ited c
inclu ding o n ly IB D ls d ia gn o se d by ERC.
