الفهرس Only 14 pages are availabe for public view
 |  | from | 203 |  |  |
| | | from | 203 | | |
Abstract
Bile duct injuries are serious and major complications of surgery in general and biliary tract surgery in particular. The incidence of biliary injuries increased after the introduction of laparoscopic surgery.
The etiologic factors for such injuries are variable, with some factors related to the patient, as presence of congenital anomalies in or around the biliary system, or extensive pathology, like excessive fibrosis in the triangle of Calot. There are factors related to the operating surgeon like inadequate training, inefficiency and inadequate incision.
Diagnosis is variable according to the time of presentation or suspect of the incidence of biliary tract injuries. Sometimes, the injury is discovered on the operating table, immediately after the infliction of injury. Sometimes, the diagnosis is delayed for more than 24 hours postoperatively. In such situations, diagnosis is variable according to whether the injury is discovered early; within the first month after infliction of the injury, or late; after the passage of many months. Those late cases usually present with jaundice due to stricture formation.
Treatment involves non-surgical modalities like observation for minor leaks, drainage for major leaks, or dilatation and stenting for strictures. Surgery involves a variety of techniques for reconstruction of the biliary tree or bilio-enteric anastomosis.
In this thesis, we studied twenty cases with different types and different durations of biliary tract injuries. The majority were laparoscopic cholecystectomy cases (70%). 20% of our cases belonged to the group of immediate intraoperative discovery. 55% discovered during the early postoperative period (within one month postoperatively). In addition, 25% of cases presented or were discovered later than one month postoperatively.