الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 114 |  |  |
| | | from | 114 | | |
Abstract
Background:
High bile duct pathology may be due to post cholecystectomy high bile duct injuries, post transplantation strictures and/or cholangiocarcinoma.
Aim of the study:
This study aimed to investigate the frequency and types of high bile duct pathologies, clinical and laboratory presentations, the types of interventions done for repair and finally the outcome of the adapted management.
Patients:
This retrospective and prospective study was conducted on patients with high bile duct pathologies. The patients were recruited from Minia University hospital, hepatobiliary unit, and Maadi Military hospital, the hepatobiliary and liver transplants unit through the period from 2016 to 2017.
Our inclusion criteria were:
1- Post Cholecystectomy ( open and laparoscopic ) High Bile duct Injuries
2- Post-transplant high bile duct strictures.
3- Hilar cholangiocarcinoma
The exclusion criteria included:
1- Low bile duct injuries.
2- Cirrhotic decompensated patients –Child C
3- Cases with sever morbidity leading to inoperability as those with Congested Heart Failure or chronic kidney disease.
4- Cases with post cholecystectomy bile duct injuries managed by ERCP
Methods:
All recruited patients signed informed written consent and were aware about the procedure that will be resorted to in the management that will be offered to him according the ethical committee guidelines of a highly specialized hepatobiliary center.
The study was approved by the Ethical Research Board of Minia Faculty of Medicine and was consistent with the declare of Helsinki 1975.
The following data were obtained from the data registry of those patients recruited retrospectively and were done for the patients who were recruited prospectively:
I- Complete history taking, demographic and clinical assessments including: A- Age, sex and BMI.
B- Presenting symptoms: abdominal pain, fever, jaundice.
C- History of any preceding disease, operations or previous trauma.
D- Abdominal examinations (to detect any previous scars, scratch marks wound failure or bile leakage, and drains).
E- Assessment of the patient’s general medical fitness.
II- Laboratory investigations which included:
A- Liver and renal biochemistry profiles.
B- Complete blood picture.
C- Coagulation profile including prothrombin time (PT), concentration (PC) and concentration.
D- Inflammatory markers: TLC, CRP.