A novel pattern of complex bile duct injury characterized by distal ligation and proximal perforation: temporary T-tube drainage as a bridge to definitive reconstruction-a case report and literature review.
- 1Department of General Surgery, Ibn Sina Emergency Hospital, Chihil Suton Road, 1st District, Kabul 1001, Afghanistan.
Abstract
Bile duct injury (BDI) is a serious complication of cholecystectomy. We report a previously unrecognized pattern of complex BDI in a 30-year-old man who presented one week after open cholecystectomy with biliary peritonitis. Endoscopic retrograde cholangiopancreatography demonstrated an abrupt common bile duct (CBD) cutoff, while magnetic resonance cholangiopancreatography revealed a biloma with features suggestive of biliary peritonitis. Exploratory laparotomy confirmed distal CBD ligation with proximal common hepatic duct perforation. Because of severe inflammation and friable tissues, definitive reconstruction was deferred, and temporary T-tube drainage was established. The T-tube was maintained for ~3 months before removal. The established tract remained temporarily patent after removal, permitting transient bile drainage during progressive fibrosis and closure. The patient was closely monitored clinically, with serial liver function tests and ultrasonography. After adequate biliary-tree dilatation, Roux-en-Y hepaticojejunostomy was performed. At 2-year follow-up, he remained asymptomatic without recurrent biliary complications.
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BibTeX
@article{safi2026novel,
title = {{A novel pattern of complex bile duct injury characterized by distal ligation and proximal perforation: temporary T-tube drainage as a bridge to definitive reconstruction-a case report and literature review.}},
author = {Mirwais Safi and Muhibullah Saifi and Nasrullah Shefayee and Hamidullah Hamid and Ehsanullah Safi and Nasratullah Nasrat and Maihan Abdullah},
journal = {Journal of surgical case reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag940},
url = {https://europepmc.org/article/MED/42898980},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - A novel pattern of complex bile duct injury characterized by distal ligation and proximal perforation: temporary T-tube drainage as a bridge to definitive reconstruction-a case report and literature review.
AU - Mirwais Safi
AU - Muhibullah Saifi
AU - Nasrullah Shefayee
AU - Hamidullah Hamid
AU - Ehsanullah Safi
AU - Nasratullah Nasrat
AU - Maihan Abdullah
PY - 2026
DA - 2026/10/19
JO - Journal of surgical case reports
DO - 10.1093/jscr/rjag940
UR - https://europepmc.org/article/MED/42898980
AB - Bile duct injury (BDI) is a serious complication of cholecystectomy. We report a previously unrecognized pattern of complex BDI in a 30-year-old man who presented one week after open cholecystectomy with biliary peritonitis. Endoscopic retrograde cholangiopancreatography demonstrated an abrupt common bile duct (CBD) cutoff, while magnetic resonance cholangiopancreatography revealed a biloma with features suggestive of biliary peritonitis. Exploratory laparotomy confirmed distal CBD ligation with proximal common hepatic duct perforation. Because of severe inflammation and friable tissues, definitive reconstruction was deferred, and temporary T-tube drainage was established. The T-tube was maintained for ~3 months before removal. The established tract remained temporarily patent after removal, permitting transient bile drainage during progressive fibrosis and closure. The patient was closely monitored clinically, with serial liver function tests and ultrasonography. After adequate biliary-tree dilatation, Roux-en-Y hepaticojejunostomy was performed. At 2-year follow-up, he remained asymptomatic without recurrent biliary complications.
SN - 2042-8812
ER -