Low serum albumin is not a contraindication for early iatrogenic bile duct injury repair.

Miguel Angel Mercado, Carlos Chan, Héctor Orozco, Eitan Podgaetz, David Estuardo Porras-Aguilar, Antonio Ramos De la Medina, Carlos A. Hinojosa, Juan José Plata-Muñoz, César Jaramillo, F. I. Oki

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Most iatrogenic bile duct injuries are recognized in the early postoperative period (first 48 hours). These patients usually have additional complications such as a suboptimal hydroelectrolitic status, subhepatic collections, external biliary fistula and malnutrition. In these circumstances, besides the elevation of bilirubin and transaminases associated with the injury, hypoalbuminemia is frequently encountered. The timing for repair is decided according to the condition of each patient. We report the impact of preoperative abnormal low serum albumin levels on the results of biliary tract reconstruction after a iatrogenic biliary lesion. METHOD: Patients who underwent biliary reconstruction in our center from 1998 to 2002 were analyzed. Only patients with complex injuries (Strasberg E, Bismuth III-IV, Stewart-Way III) were included. Major postoperative complications were recorded and correlated with preoperative liver function tests. RESULTS: Seventy seven patients were analyzed. In 41 cases, the injury was a consequence of a laparoscopic operation. All patients were treated by a Roux-en-Y hepatojejunostomy. No operative mortality was recorded. The most frequent postoperative complications were postoperative biliary fistula (8/77-9%, p < 0.017) and subhepatic collections (9/77-9%, p < 0.39). All fistulae closed spontaneously and the subhepatic collections were drained. Overall, complications were more common in the group with hypoalbuminemia (p < 0.002). CONCLUSION: Early repair is indicated if there is no systemic contraindication (sepsis, multiple organic failure, electrolytic imbalance). Abnormalities in the liver function tests, particularly a low serum albumin, should not delay the operation. Although significantly more postoperative complications are observed in an early repair, long-term results are comparable to those of an elective repair.

Original languageEnglish (US)
Pages (from-to)184-187
Number of pages4
JournalAnnals of hepatology : official journal of the Mexican Association of Hepatology
Issue number3
StatePublished - 2005
Externally publishedYes

Bibliographical note

This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine


Dive into the research topics of 'Low serum albumin is not a contraindication for early iatrogenic bile duct injury repair.'. Together they form a unique fingerprint.

Cite this