Timing and Surgical Strategies for Reconstruction of Iatrogenic Bile Duct Injury Following Cholecystectomy: A Retrospective Cohort Study

We conducted a retrospective cohort study of 54 consecutive patients with major BDI (Strasberg D/E) at a tertiary hepatobiliary center (2014-2022). Management followed a predefined protocol stratified by presentation timing and clinical status: Immediate repair (<72 h; n=22), Early delayed repair (~2 weeks; n=12), or Late delayed repair (3 months after initial drainage; n=12). Critically ill patients (n=8) underwent resuscitation before any definitive repair. The primary outcome was treatment success, defined as absence of anastomotic stricture or recurrent cholangitis requiring intervention. Factors associated with outcome were investigated in regression analysis.