Table 1.
Type of bile-duct injury, initial management and outcome of those who developed a pseudoaneurysm in the hepatic artery
Age (years) and sex | Type of injury | Initial management | Outcome of bile-duct injury |
---|---|---|---|
74, Male | Strasberg A | Not recognised on table. Readmitted with biliary peritonitis. ERCP failed twice. Laparotomy and repair of leak in cystic stump. | Needed further percutaneous drainage of a collection. Died of multiple-organ failure 29 days after embolisation of pseudoaneurysm. |
70, Female | Strasberg A | Not recognised on table. ERCP + stenting and percutaneous drainage. | Leak settled in a few days. Well at 16-month follow-up. |
76, Male | Strasberg E2 | On-table repair: hepaticojejunostomy by specialist team. | No leak; no stricture. |
56, Male | Strasberg E2 | Recognised on table; T-tube drainage. | Developed mid-CBD stricture 20 months later needing hepaticojejunostomy. |
66, Male | Strasberg E2 | On table. Hepaticojejunostomy by specialist team. | Early bile leak, settled with PTC and drainage. Developed anastomotic stricture that was dilated by a percutaneous approach 56 months later. |
64, Female | Strasberg E2 | On-table repair: hepaticojejunostomy with reconstruction of the injury to the right hepatic artery. | Bile leak on day-12, resolved with percutaneous drainage. |
59, Male | Strasberg E3 | Suspected right-posterior sectoral duct injury oversewn by primary surgeon. | Developed obstructive jaundice from biliary stricture (E3). Hepaticojejunostomy done 3 months after a laparoscopic cholecystectomy. Well at 43-month follow-up. |
54, Male | Strasberg E3 | On-table hepaticojejunostomy by primary surgeon. | Developed anastomotic stricture 1 year after initial surgery necessitating revision |
ERCP = endoscopic retrograde cholangiopancreatography; CBD = common bile duct; PTC = percutaneous transhepatic cholangiography