Improved outcomes of bile duct injuries in the 21st century

Henry A. Pitt, Stuart Sherman, Matthew S. Johnson, Andrew N. Hollenbeck, Jonathan Lee, Michael R. Daum, Keith D. Lillemoe, Glen A. Lehman

Research output: Contribution to journalArticlepeer-review


Objective: The objectives of this analysis were to compare the outcomes of bile duct injuries by specialist over time and the role of management timing and biliary stents. Background: Postoperative bile duct injuries require multidisciplinary management. In recent years, advancements have occurred in patient evaluation and in timing and type of therapy. Methods: A multidisciplinary team managed 528 patients over 18 years. Mean age was 52 years; 69% were women and 95% had a cholecystectomy and/or bile duct exploration. Patients were classified by the Strasberg system as having bile leaks (type A, n = 239, 45%) or bile duct injuries (types B-E, n = 289, 55%). Injury outcomes from 1993 to 2003 (n = 132) were compared with those from 2004 to 2010 (n = 157). A successful outcome was defined as no need for further intervention after the initial 12 months of therapy. Standard statistical methods were employed. Results: Patients with bile leaks were managed almost exclusively by endoscopists (96%) with a 96% success rate. Patients with bile duct injuries were managed most often by endoscopists (N = 115, 40%) followed by surgeons (N = 104, 36%) and interventional radiologists (N = 70, 24%). Overall success rates were best for surgery (88%, P

Original languageEnglish (US)
Pages (from-to)490-497
Number of pages8
JournalAnnals of Surgery
Issue number3
StatePublished - Sep 2013
Externally publishedYes


  • Bile duct injury
  • Bile duct stricture
  • Bile leak and cholecystectomy

ASJC Scopus subject areas

  • Surgery


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