Iatrogenic Bile Duct Injury Following Cholecystectomy, Surgical Management and Outcome: A Single Center Experience
Bibliographic record
Abstract
Background and objectives: Iatrogenic bile duct injury (IBDI) is a serious complication during cholecystectomy caused by a surgeon in apparently healthy patients and is associated with a significant rate of morbidity and a low rate of mortality. Our aim was to review the surgical repair of IBDI and post-operative outcomes regarding morbidity and mortality. Methods: We retrospectively analyzed the surgical management and outcome of biliary injuries during cholecystectomy in 52 patients diagnosed intraoperatively during cholecystectomy or referred postoperatively to Sulaymaniyah digestive and liver surgery center between May 2014 and May 2017. Results: During these three years; we managed 52 patients of which 41 patients (78.8%) were females. Forty-seven bile duct injuries happened during laparoscopic cholecystectomy and in 5 patients during open-type surgery. Eight patients were diagnosed intraoperatively the remaining 44 were diagnosed post-operatively. The most common type of injury was Strasbourg type E2 (33 patients, 63.5%). The mean age of patients was 32 years in females and 36 years in males. Roux-en- Y hepati- cojejunostomy was the surgical treatment in 47 patients (90.4%). Post-operative morbidity within three years was 34.6% and mortality was 3.8%. Patients were followed for one month on their regular visit to our center or private clinic post-operatively then followed by their irregular visits once they had complains within the period of our study. Conclusions: Hepaticojejunostomy was the best surgical procedure for repair of IBDI with less postoperative morbidity and mortality in our study, IBDI type E4 according to Strasberg classification associated with more morbidity and mortality than other types.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".