Is it before 72 hours?
Before 1 week?
Before 10 days?
Rarely in clipped injurlies before 2 week??
I think time duration is not important .. if it is well controlled injury with a drain in place and if there is no general peritoneal contamination an experienced surgeon who has repaired more than 20 BDI can repair it any time ..
on the other hand undrained collections requiring reinsertion of pigtails/ drain even the best surgeons should refrain repair beyond 1 week and delay it upto not more than six weeks
Yes early is less then 72 hours but 2 meta analysis failed to conclude what exactly early is as the available material is so vague about defining..
Even though there is no exact definition.early repair is taken as repair done before 72 hrs ...
Ideally repair shld be done after 6 weeks ,or even after 8 weeks
1.no intraabdominal collection
2.no clinical signs of sepsis
3.deatiled imaging of bile duct anatomy
4. Presence of any continuity of the duct
5.angio - to look for RHA associated injury
6.atrophy hypertrophy complex if any
If there is a drain and no distal obstruction, I will wait for 6 weeks. The general condition of the patient will play a role in surgery timing too.
Otherwise, I will go to urgent surgery, when none of the three above circumstances are not well fulfilled.
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