Causes and Results of Repeated Operations in Iatrogenic Lesions of the Biliary System

Abstract

Introduction: Iatrogenic injuries, resulting from medical interventions, often necessitate repeat surgeries, which
pose significant challenges for patients and health-care systems. This retrospective study aimed to evaluate the
occurrence and outcomes of various procedures for iatrogenic injuries, focusing on liver and bile duct traumas.
Methods: The study included 110 patients aged 34–72 years who underwent reoperation due to surgical
complications at two leading medical centers in Bishkek, Kyrgyzstan, from 2015 to 2023. Of these, 21 (19.3%)
patients required additional surgery, primarily due to iatrogenic harm to the liver and bile ducts during initial
operations, predominantly laparoscopic cholecystectomies for cholelithiasis. The diagnostic approach incorporated
clinical assessment, imaging studies, and laboratory analysis. Results: Reoperations varied according to injury
type and severity, with immediate operations conducted on 17 (81%) patients and delayed reconstructive surgeries
performed on 4 (19%) patients. Post-reoperation complications occurred in 5 (23.8%) patients, and the average
hospital stay was 14 days. The study reported a 4.8% mortality rate, highlighting the significant risks associated
with surgical management of iatrogenic injuries. Conclusion: Effective management of these injuries requires a
comprehensive approach that prioritizes patient safety, quality of care, and efficient resource utilization. Ongoing
professional development, adherence to guidelines, and continued research on prevention and innovative surgical
techniques are essential to reduce the occurrence of iatrogenic injuries and improve patient outcomes.