DOI: https://doi.org/10.36347/sasjs.2025.v11i07.013

Pages: 839-844

Background: Bile duct injury (BDI) remains a serious complication following laparoscopic cholecystectomy, significantly impacting patient morbidity, surgical complexity, and long-term outcomes. Optimal management depends on timely diagnosis and accurate classification of the injury. This study aimed to correlate BDI classification, as per the Bismuth system, with the type of surgical management utilized and corresponding clinical outcomes. Methods: A cross-sectional observational study was conducted over one year across five tertiary hospitals in Dhaka, Bangladesh. Twenty patients diagnosed with post-laparoscopic cholecystectomy BDI within six months of surgery were enrolled. Clinical records, imaging, and laboratory tests were reviewed. Injuries were classified according to the Bismuth system. Surgical management strategies, perioperative findings, complications, and follow-up outcomes were documented and analyzed using SPSS version 25.0. Results: The most frequent injury types were Bismuth Grade 2 (35%) and Grade 3 (30%). Controlled biliary fistula (45%) and Roux-en-Y hepaticojejunostomy (30%) were the predominant surgical interventions. Subhepatic collections (75%) and high-level strictures (40%) were common intraoperative findings. Postoperative complications included wound infection (30%), chest infection (15%), and one mortality (5%). Follow-up revealed that 40% of patients were asymptomatic, while 20% experienced recurrent cholangitis and 5% developed strictures. Conclusion: A significant correlation exists between BDI classification and the choice of surgical approach. Early recognition, precise injury grading, and multidisciplinary care are critical for improving outcomes in BDI management.