47900 Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)

Name of the Procedure:

Suture of Extrahepatic Biliary Duct for Pre-existing Injury (Separate Procedure)

Summary

This procedure involves the repair of a bile duct that is located outside the liver. It is performed when there is a pre-existing injury to the duct. The surgeon uses sutures to mend the duct, ensuring proper bile flow from the liver to the intestine.

Purpose

This procedure addresses injuries to the extrahepatic bile ducts. The goal is to restore normal bile flow, preventing complications like bile leakage, infections, and jaundice.

Indications

• Pre-existing injury to the extrahepatic bile duct.
• Symptoms such as abdominal pain, jaundice, fever, or bile leaks.
• Conditions like bile duct strictures or perforations.
• Traumatic or iatrogenic (surgery-related) injuries to the bile duct.

Preparation

• Follow fasting instructions prior to surgery.
• Adjust or stop certain medications as directed by the healthcare provider.
• Undergo diagnostic tests like blood tests, imaging studies (e.g., MRI, CT scans), or endoscopic procedures.

Procedure Description

1. Under anesthesia, an incision is made to access the injured bile duct.
2. The site of injury is identified.
3. The surgeon sutures the injured bile duct to repair it.
4. Additional drains or stents may be placed to ensure proper bile flow during healing.
5. The incision is closed once the repair is complete.

Tools and Technology

• Surgical sutures and needles.
• Specialized surgical instruments.
• Imaging tools (e.g., intraoperative cholangiogram).

Anesthesia

• General anesthesia is typically used.

Duration

The procedure usually takes around 1 to 3 hours, depending on the extent of the injury.

Setting

Performed in a hospital operating room.

Personnel

• A surgeon, often a biliary or general surgeon.
• An anesthesiologist.
• Surgical nurses and assistants.

Risks and Complications

• Infection
• Bile leakage
• Stricture formation (narrowing of the duct)
• Bleeding
• Injury to surrounding organs
• Reaction to anesthesia

Benefits

• Restoration of normal bile flow.
• Prevention of complications like infections, jaundice, and bile leaks.
• Improved quality of life and liver function.

Recovery

• Hospital stay for a few days post-surgery.
• Follow wound care instructions.
• Gradual return to normal activities over a few weeks.
• Follow-up appointments to monitor healing and biliary function.

Alternatives

• Non-surgical management with stents or drainage (temporary solution).
• Endoscopic procedures (ERCP) for stent placement.

Pros and Cons

• Non-surgical methods have quicker recovery but may not be permanent solutions.
• Surgical repair offers a definitive solution but involves longer recovery and higher risks.

Patient Experience

• Under general anesthesia, the patient will not feel or remember the procedure.
• Post-operatively, patients may experience some pain and discomfort which can generally be managed with pain medication.
• Gradual improvement in symptoms related to bile flow issues and full recovery expected in weeks.