Extrahepatic Biliary Tract Injuries

Abstract

Background Extra hepatic biliary tract (EBT) injuries are injuries that involve the gall bladder (GB), the common hepatic (CHD) and the common bile ducts (CBD). They are rarely encountered during external abdominal traumas. They are serious and associated with high morbidity and mortality when the ductal system is involved and because of the associated visceral and vascular injuries and thus they need special care to be diagnosed early, and managed properly. Objectives: To study the incidence, clinical presentation, management, and complications of extrahepatic biliary tract injuries. Methods Retrospective review was done for all the patients who had laparotomy for their abdominal traumas during a year at Al Yarmouk Teaching Hospital with special emphasis on extrahepatic biliary tract injuries. Results Nearly 700 people had severe abdominal injuries necessitating an explorative laparotomy for their management. Out of this number only 8 definite extrahepatic biliary tract injuries were discovered. 6 of them had cholecystectomy and 2 had biliary ductal injuries for which drainage was the major step in their management. 4 cases were labeled to have missed EBT injuries. Conclusion Extrahepatic biliary injuries are rare coincidences on exploring traumatized abdomen. They are serious injuries associated with high morbidity and mortality when the ductal system is involved and are usually accompanied by severe other visceral injuries. Their management should be done by the most senior surgeon and if possible in a well equipped center.