Systematic Reviews
Copyright ©The Author(s) 2021.
World J Hepatol. Feb 27, 2022; 14(2): 442-455
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.442
Table 1 Descriptive cohort, n (%)
Ref.
Study period
Study population (n)
Major BDI (n)
de Reuver et al[20], 20071991- 2005500151 (30)
Mushtaq et al[35], 20201974- 2004500011 (100)
Goykhman et al[28], 20082002- 20072929 (100)
Silva et al[34], 2008-2222 (100)
Stewart et al[18], 2009-307307(100)
Sahajpal et al[42], 20101992-20076969 (100)
Huang et al[25], 20111984- 200928241 (15)
Perera et al[26], 20111991- 2007200157 (79)
Barauskas et al[41], 20122000- 2007443823 (53)
Iannelli et al[27], 2013-640543 (85)
Lubikowski et al[38], 20122002- 2011300 (TPL)5 (100, TPL)
Parrilla et al[37], 20141987- 20102727 (100, TPL)
Stilling et al[44], 20151995-2010139139 (100)
Arora et al[46], 20152000- 20101010 (100)
Perini et al[36], 20152000 – 20111489 (16, LR)
Sulpice et al[33], 20141992- 20106038 (63)
Felekouras et al[40], 20151991- 20116767 (100)
Kirks et al[45], 20162008- 20056161 (100)
Dominguez-Rosado et al[43], 20161989- 2014699614 (88)
E-AHPBA[47], 20192000-2016913913 (100)
Battal et al[48], 20192012-20171313 (100)
Sweigert et al[49], 20212006-201511681168 (100)
El Nakeeb et al[50], 20212015-2020412412 (100)
Anand et al[51], 20212013- 2020105105 (100)
Total 15.6094934
BDI: Bile duct injury; LR: Liver resection; TPL: Liver transplantation.
Table 2 Classification systems of bile duct injury
Ref.BDI (n)ClassificationBismuth classification
Strasberg classification
Vascular injury
I
II
III
IV
V
A
B
C
D
E1
E2
E3
E4
E5
de Reuver et al[20]151 Bismuth373737------------
Mushtaq et al[35]11 None---------------
Goykhman et al[28]29 None-------------5
Silva et al[34]22 Strasberg------1-1177322
Stewart et al[18]307Stewart167218732---
Sahajpal et al[42]69Strasberg1--222162242-
Huang et al[25]41None-------------- -
Perera et al[26]157 Strasberg-----192926206537193-
Barauskas et al[41]23 Strasberg-----(4)--(17)121-1--
Iannelli et al[27]543None---------------
Lubikowski et al[38]5 Strasberg-----12---11---
Parrilla et al[37]27 Strasberg----------41112-7
Stilling et al[44]139Bismuth49493526
Arora et al[46]10Strasberg-13510
Perini et al[36]9 Strasberg-----------27-9
Sulpice et al[33]38 Strasberg----61469310
Felekouras et al[40]67 Strasberg7-41810262241-
Kirks et al[45]61Strasberg21741016116112
Dominguez-Rosado et al[43]614Strasberg44816622
E-AHPBA[47]913Strasberg757126
Battal et al[48]13Strasberg3411
Sweigert et al[49]1168None
El Nakeeb et al[50]412Strasberg5923480336
Anand et al[51]105Bismuth1037433
TOTAL 49341121952676703462071134161320426519222
Various classification systems were used among studies and a relevant portion of studies did not declare any classification system of BDI.
Table 3 Timing of bile duct injury repair, n (%)
Ref.
Surgical repair (n)
Definition IR
IR (n)
Definition ER
ER (n)
Defintion DR
DR (n)
Definition LR
LR (n)
In favor of
de Reuver et al[20]151< 6 w15 (10)--> 6 w96 (64)> 6 w (R)40 (27)-
Mushtaq et al[35]11Initial surgery11 (100)-------
Goykhman et al[28]29Initial surgery14 (48)--24-72 h5 (17)> 8 w10 (35)Delay
Silva et al[34]22Initial surgery22 (100)----
Stewart et al[18]300Initial surgery163 (53)1-2 w61 (20)3-6 w 33 (11)> 6 w43 (14)
Sahajpal et al[42]69≤ 3 d13 (19)3d- 6w34 (49)> 6 w22 (32)Immidiate or delay
Huang et al[25]41--< 14 d19 (46)14-24 w22 (54)--Early
Perera et al[26]112Initial surgery28 (18)< 21 d43 (27)> 21 d41 (26)--Early
Barauskas et al[41]23Initial surgery3 (13)-7 (30)-13 (57)---
Iannelli et al[27]543Initial surgery194 (35)< 45 d216 (39)> 45 d133 (24)--Delay
Lubikowski et al[38]5 (TPL)-------5 (100)-
Parrilla et al[37]27 (TPL)-------27 (100)-
Stilling et al[44]139-
Arora et al[46]10≤ 3 d10 (100)
Perini et al[36]9 (LR)-------9 (100)-
Sulpice et al[33]35< 3 d15 (43)3 d–6 w7 (20)> 6 w4 (11)> 24 mo9 (26)-
Felekouras et al[40]67< 14 d34 (51)2-12 w11 (16)> 12 w22 (33)---
Kirks et al[45]61≤ 2 d27 (44)> 2 d34 (56)Equal
Dominguez-Rosado et al[43]614< 7 d61 (10)1-6 w152 (26)> 6 w374 (63)Early or late
E-AHPBA[47]913< 7 d339 (37)1-6 w261 (28.6)6 w-6 mo313 (34)Equal
Battal et al[48]13< 3 d13 (100)
Sweigert et al[49]1168< 3 d569 (48)4 d-6 w439 (38) > 6 w169 (15)Early or late
El Nakeeb et al[50]412< 3 d156 (38)4-6 w75 (18)> 6 w181 (44)Early or delayed
Anand et al[51]105--< 12 w21 (20)--> 12 w84 (80)NS
TOTAL4879705 (14)1367 (28)1364 (28)1286 (26)
IR: Immediate repair; ER: Early repair; DR: Delayed repair; LR: Late repair; TPL Transplantation; LR: Liver resection.
Table 4 Outcome according to timing of bile duct injury repair
Timing of repair
Immediate n = 705
Early n = 1378
Delayed n = 1364
Late n = 1286
P
Type of surgery
HJS 89 (72-100)77 (75-91)100 (96-100)95 (91-100)0.132
End-to-end 32 (19-57)21 (13-47)3 (2-10)-0.265
Complications 34 (21-41)21 (20-29)25 (16-36)28 (19-38)0.789
Bile leak21 (12-36)7 (5-12)12 (0-24)5 (5-14)0.653
Wound infection23 (12-35)-10 (7- 28)9 (7-12)0.456
Liver dysfunction8 (5-11)----
Cholangitis11 (10-31)11 (7-25)13 (8- 59)10 (4-18)0.684
Jaundice9 (4-14)----
Redo HJS33 (3-43)8 (3-31)20 (10-31)3 (1-8)0.642
Intervention16 (14- 17)5 (2-12)24 (23- 25)-0.035
Stricture17 (13-41)29 (14-39)25 (15- 62)13 (11- 19)0.821
Time to stricture 11 (4-29)50 (12-89)14 (14-30)-0.642
Mortality 1 (0-5)2 (0-1)3 (1-5)00.832
HJS: Hepaticojejunostomy.
Table 5 Outcome after bile duct injury within 14 d or later
Timing of repair
≤ 14 d (n = 1757)
> 14 d (n = 2031)
P
Type of surgery
HJS 100 (73-100)100 (68-100)0.842
End-to-end 0 (0-27)0 (0-5)0.352
Complications 33 (21-41)22 (18-25)0.085
Bile leak11 (5-21)6 (0-12)0.453
Wound infection5 (0-14)9 (6-18)0.593
Abnormal liver function11 (0-21)10-
Cholangitis11 (10-35)9 (9-10)0.348
Jaundice13 (5-21)--
Redo HJS23 (4-42)0-
Intervention16 (14-18)17-
Stricture18 (12-43)13 (5-23)0.352
Time to stricture (mo)17 (10-62)3-
Mortality 2 (0-3)4 (3-5)0.203
After exclusion of overlapping definitions of timing, two groups at a cut off of 14 d were formed. Again outcome was comparable between early (≤ 14 d) and delayed (> 14 d) BDI repair. HJS: Hepaticojejunostomy.