The present study was designed to evaluate the results of different
preoperative techniques for accurate localization of biliary tract injury.
Thirty patients (21 females and 9 mnlPs) were included in this study. The
clinical diagnosis was post operative bile duct injury. They presented
mainlywith jaundice, pain, dyspepsia, intermittent fever and other symptoms.
Ultrasonography done to all patients, intrahepatic biliary radicle dilation,
common bile duct dilatation and bile collection were evident findings.
The accurate site of pathology was not clear in most of the cases. Percutaneous
trartshepatic (Pit) done for three patients with high serum bilirubin,
after drainage PTC done. Intrahepatic biliary dilatation, proximal segment
accurately localizecL One patient developed biliary leakage.
Retrograde cholangiopancreatography (ERCP) done for twenty patients, it
clearly visualized the distal segment of the biliary tract. ERCP was helpful
in diagnosis strictures. Failed cannulation occurred in five patients.
Two patients developed cholangitis after ERCP.
Magnetic resonance cholangiopancreatography (MRCP) done to ten patients.
The findings was clear where proximal and distal segments were
delineated as well as the intrahepatic dilated biliary radicles.
From this study it was concluded that diagnosis of biliary tract injury
could start with ultrasonography examination, followed by MRCP to localize
the site of the pathology and the proximal segment before biliary reconstruction. |
