Impact of timing of repair on outcomes of patients repaired with Hepp-Couinaud hepatico-jejunostomy (HC-HJ) after bile duct injury (BDI) during cholecystectomy remains debated. This is an observational retrospective study at a tertiary referral hepato-biliary center. HC-HJ was always performed in patients without sepsis or bile leak and with dilated bile ducts. Timing of repair was classified as: early (≤ 2 weeks), intermediate (> 2 weeks, ≤ 6 weeks), and delayed (> 6 weeks). 114 patients underwent HC-HJ between 1994 and 2022: 42.1% underwent previous attempts of repair at referring institutions (Group A) and 57.9% were referred without any attempt of repair before referral (Group B). Overall, a delayed HC-HJ was performed in 78% of patients; intermediate and early repair were performed in 17% and 6%, respectively. In Group B, 10.6% of patients underwent an early, 27.3% an intermediate, and 62.1% a delayed repair. Postoperative mortality was nil. Median follow-up was 106.7 months. Overall primary patency (PP) attainment rate was 94.7%, with a 5- and 10-year actuarial primary patency (APP) of 84.6% and 84%, respectively. Post-repair bile leak was associated with PP loss in the entire population (odds ratio [OR] 9.75, 95% confidence interval [CI] 1.64–57.87, p = 0.012); no correlation of PP loss with timing of repair was noted. Treatment of anastomotic stricture (occurred in 15.3% of patients) was performed with percutaneous treatment, achieving absence of biliary symptoms in 93% and 91% of cases at 5 and 10 years, respectively. BDI can be successfully repaired by HC-HJ regardless of timing when surgery is performed in stable patients with dilated bile ducts and without bile leak.

胆囊切除术期间胆管损伤 (BDI) 后采用 Hepp-Couinaud 肝空肠吻合术 (HC-HJ) 修复的患者的修复时机对结果的影响仍存在争议。这是在三级转诊肝胆中心进行的一项观察性回顾性研究。HC-HJ 始终在没有败血症或胆漏且胆管扩张的患者中进行。修复时间分为：早期（≤ 2 周）、中期（> 2 周、≤ 6 周）和延迟（> 6 周）。1994 年至 2022 年间，有 114 名患者接受了 HC-HJ：42.1% 的患者之前曾在转诊机构尝试过修复（A 组），57.9% 的患者在转诊前未尝试进行任何修复（B 组）。总体而言，78% 的患者进行了延迟 HC-HJ；进行中期修复和早期修复的比例分别为 17% 和 6%。B 组中，10.6% 的患者接受了早期修复，27.3% 的患者接受了中期修复，62.1% 的患者接受了延迟修复。术后死亡率为零。中位随访时间为 106.7 个月。总体初次通畅率 (PP) 达标率为 94.7%，5 年和 10 年精算初次通畅率 (APP) 分别为 84.6% 和 84%。修复后胆漏与整个人群的 PP 损失相关（比值比 [OR] 9.75，95% 置信区间 [CI] 1.64–57.87，p  = 0.012）；没有注意到 PP 损失与修复时间的相关性。通过经皮治疗吻合口狭窄（15.3%的患者发生），5年和10年分别有93%和91%的病例没有出现胆道症状。对于胆管扩张且无胆漏的稳定患者，无论何时进行手术，HC-HJ 都可以成功修复 BDI。