Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy
Background. Concomitant vascular injury might adversely impact outcomes after iatrogenic bile duct injury (IBDI). Whether a new HPB center should embark upon repair of complex biliary injuries with associated vascular injuries during learning curve is unknown. The objective of this study was to dete...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | International Journal of Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2016/2647130 |
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| author | Abu Bakar Hafeez Bhatti Faisal Saud Dar Haseeb Zia Muhammad Salman Rafique Nusrat Yar Khan Mohammad Salih Najmul Hassan Shah |
| author_facet | Abu Bakar Hafeez Bhatti Faisal Saud Dar Haseeb Zia Muhammad Salman Rafique Nusrat Yar Khan Mohammad Salih Najmul Hassan Shah |
| author_sort | Abu Bakar Hafeez Bhatti |
| collection | DOAJ |
| description | Background. Concomitant vascular injury might adversely impact outcomes after iatrogenic bile duct injury (IBDI). Whether a new HPB center should embark upon repair of complex biliary injuries with associated vascular injuries during learning curve is unknown. The objective of this study was to determine outcome of surgical management of IBDI with and without vascular injuries in a new HPB center during its learning curve. Methods. We retrospectively reviewed patients who underwent surgical management of IBDI at our center. A total of 39 patients were included. Patients without (Group 1) and with vascular injuries (Group 2) were compared. Outcome was defined as 90-day morbidity and mortality. Results. Median age was 39 (20–80) years. There were 10 (25.6%) vascular injuries. E2 injuries were associated significantly with high frequency of vascular injuries (66% versus 15.1%) (P=0.01). Right hepatectomy was performed in three patients. Out of these, two had a right hepatic duct stricture and one patient had combined right arterial and portal venous injury. The number of patients who developed postoperative complications was not significantly different between the two groups (11.1% versus 23.4%) (P=0.6). Conclusion. Learning curve is not a negative prognostic variable in the surgical management of iatrogenic vasculobiliary injuries after cholecystectomy. |
| format | Article |
| id | doaj-art-73b55dc65f1b4c4bb72ceae9eeecb958 |
| institution | Kabale University |
| issn | 2090-3448 2090-3456 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hepatology |
| spelling | doaj-art-73b55dc65f1b4c4bb72ceae9eeecb9582025-02-03T06:07:35ZengWileyInternational Journal of Hepatology2090-34482090-34562016-01-01201610.1155/2016/26471302647130Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after CholecystectomyAbu Bakar Hafeez Bhatti0Faisal Saud Dar1Haseeb Zia2Muhammad Salman Rafique3Nusrat Yar Khan4Mohammad Salih5Najmul Hassan Shah6Department of HPB and Liver Transplantation, Shifa International Hospital, Islamabad 44000, PakistanDepartment of HPB and Liver Transplantation, Shifa International Hospital, Islamabad 44000, PakistanDepartment of HPB and Liver Transplantation, Shifa International Hospital, Islamabad 44000, PakistanDepartment of Radiology, Shifa International Hospital, Islamabad 44000, PakistanDepartment of HPB and Liver Transplantation, Shifa International Hospital, Islamabad 44000, PakistanDepartment of Hepatology, Shifa International Hospital, Islamabad 44000, PakistanDepartment of Hepatology, Shifa International Hospital, Islamabad 44000, PakistanBackground. Concomitant vascular injury might adversely impact outcomes after iatrogenic bile duct injury (IBDI). Whether a new HPB center should embark upon repair of complex biliary injuries with associated vascular injuries during learning curve is unknown. The objective of this study was to determine outcome of surgical management of IBDI with and without vascular injuries in a new HPB center during its learning curve. Methods. We retrospectively reviewed patients who underwent surgical management of IBDI at our center. A total of 39 patients were included. Patients without (Group 1) and with vascular injuries (Group 2) were compared. Outcome was defined as 90-day morbidity and mortality. Results. Median age was 39 (20–80) years. There were 10 (25.6%) vascular injuries. E2 injuries were associated significantly with high frequency of vascular injuries (66% versus 15.1%) (P=0.01). Right hepatectomy was performed in three patients. Out of these, two had a right hepatic duct stricture and one patient had combined right arterial and portal venous injury. The number of patients who developed postoperative complications was not significantly different between the two groups (11.1% versus 23.4%) (P=0.6). Conclusion. Learning curve is not a negative prognostic variable in the surgical management of iatrogenic vasculobiliary injuries after cholecystectomy.http://dx.doi.org/10.1155/2016/2647130 |
| spellingShingle | Abu Bakar Hafeez Bhatti Faisal Saud Dar Haseeb Zia Muhammad Salman Rafique Nusrat Yar Khan Mohammad Salih Najmul Hassan Shah Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy International Journal of Hepatology |
| title | Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy |
| title_full | Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy |
| title_fullStr | Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy |
| title_full_unstemmed | Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy |
| title_short | Prognostication of Learning Curve on Surgical Management of Vasculobiliary Injuries after Cholecystectomy |
| title_sort | prognostication of learning curve on surgical management of vasculobiliary injuries after cholecystectomy |
| url | http://dx.doi.org/10.1155/2016/2647130 |
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