Background: Cardiac complications remain a major cause of perioperative morbidity and mortality globally among patients undergoing noncardiac surgery. In Nepal, implementing international guidelines is challenging due to resource constraints, workforce variability, and a high burden of rheumatic heart disease, early-onset coronary artery disease and chronic obstructive pulmonary diseases. Objective: To develop standardized, evidence-based recommendations for preoperative cardiac evaluation for adult patients undergoing noncardiac surgeries focussed on Nepalese context. Methods: Cardiac Society of Nepal coordinated a three-round modified Delphi process amongst cardiologists, anesthesiologists, and surgeons from healthcare institutions across Nepal. The AGREE II framework guided guideline development, and DELPHISTAR standards ensured transparent reporting. Consensus was defined as >= 70% "Strongly Agree" or >= 80% "Strongly Agree + Agree". Results: Consensus was achieved on 26 key recommendations covering screening, risk stratification, prehabilitation, surgical and institutional considerations. These recommendations adapt international best practices to Nepal's specific challenges, prioritizing low cost tests like ECG, selective use of echocardiography and biomarkers, and addressing modifiable risk factors preoperatively. Conclusion: This multidisciplinary consensus provides a context-appropriate, pragmatic framework for preoperative cardiac evaluation in Nepal. It aims to improve perioperative outcomes, support coordinated perioperative care, and guide national perioperative quality standards and future research.

Background: The surgical education is different than other disciplines of medical training because the education requires transfer of knowledge along with the surgical skills. Due to COVID-19 pandemic, the conventional method of teaching learning activities had been affected. The aim of this study was to analyze the impact of COVID-19 on post graduate surgical education during the pandemic. Methods: A prospective cross sectional analytical study was conducted at National Academy of Medical Sciences from February 2021 till June 2023. The study population were residents in General Surgery, Orthopaedics and Trauma Surgery, Dental and maxillofacial surgery and Ear, Nose Throat (ENT) /Head and Neck SurgeryPost Graduate programs who required skills training at National Academy of Medical Sciences. The data was collected by structured questionnaire and the data analysis was done using Microsoft Excel program and SPSS software for proportion of impact in different domains compared with Likert scale values. The P value <0.05 was considered statistically significant. Result: There was total 66 residents which included 29 from General surgery, 16 from Orthopedics and trauma, 10 from Maxillofacial surgery and 11 from ENT Head and neck surgery. The residents who felt that their elective surgical skills learning was affected was 57(86%) and the residents who felt that their emergency surgical skills learning were affected by COVID-19 pandemic was 43(65%). The residents of general surgery, orthopedic/ trauma surgery and ENT / Head and Neck surgery felt that most that their elective surgical skills learning was affected. The emergency surgical skills learning was affected most in ENT/Head and Neck surgery program. Conclusion: There was a an impact of COVID-19 on learning elective skills. The learning of elective surgical skills was affected most during COVID-19 pandemic and felt most in general surgery, orthopedics/trauma surgery and ENT/head and neck training programs

Introduction: In Nepal, breast cancer is the second most common cancer accounting for a large number of deaths.The subtype Triple-negative breast cancer (TNBC) is linked to poor prognosis and is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). This study describes the outcome of women with TNBC as compared to other breast cancers in Bir Hospital in Nepal. Methods: This was a cross-sectional study conducted in Bir Hospital, National Academy of Medical Sciences. The breast cancer data in Department of Surgery and Department of Oncology were collected from July 2021 to June 2024. The study data on demographic details, clinical findings, radiological and pathological investigations, operative procedures, neoadjuvant/adjuvant therapy, surgical and oncological outcomeswere collected. The study approval was taken from Institutional Review Board of National Academy of Medical Sciences. Results: There were 72 breast cancer patientsout of which 10 (13.8 %) were TNBC. Majority of the cases (70%) underwent modified radical mastectomy and 60% of them had received neoadjuvant therapy in TNBC cases. One out of 10 had positive margin post mastectomy. The proportion of TNBC patients with postoperative wound infection, seroma and flap necrosis were 10% each. The mean lymph node positivity was less in TNBC group as compared to other breast cancers.There was one recurrence, one metastasis and no mortality till one year follow up. Conclusion: The surgical outcome was satisfactory and with neo-adjuvant, surgery and adjuvant therapy, there is less tumor recurrence and satisfactory disease free survival and overall survival.

Choledochoduodenal fistula is an abnormal connection between the common bile duct and the duodenum. The commonest cause is cholecystolithiasis, however, other causes are iatrogenic factors, bile duct stones (choledocholithiasis), and chronic duodenal ulcers. Here, we report a case of choledochoduodenal fistula secondary to long standing choledocholithiasis post cholecystectomy who presented with intermittent abdominal pain in the past three years which revealed choledochoduodenal fistula during Endoscopic Retrograde Cholangiopancreatography. As the patient had recurrent pain along with choledocholithiasis, surgical intervention was indicated. Choledochoduodenal fistula is suspected in case of recurrent cholangitis and surgery is recommended for refractory and complicated cases. Surgical treatment is also recommended for larger fistulas and especially with non-resolving medical treatment. This case highlights the treatment option for choledocholithiasis with choledochoduodenal fistula.

Background & objectives Injuries profoundly impact global health, with substantial deaths and disabilities, especially in low- and middle-income countries (LMICs). This paper presents strategic consensus from the Transdisciplinary Research, Advocacy, and Implementation Network for Trauma in India (TRAIN Trauma India) symposium, advocating for enhanced, system-level trauma care to address this challenge. Methods Five working groups conducted separate literature reviews on pre-hospital trauma care, in-hospital trauma resuscitation and training, trauma systems, trauma registries, and India’s Towards Improving Trauma Care Outcomes (TITCO) registry. Using a Delphi approach, the TRAIN Trauma India Symposium generated consensus statements and recommendations for interventions to streamline trauma care and reduce preventable trauma mortality in India and LMICs. Experts prioritized interventions based on cost and difficulty. Results An expert panel agreed on four pre-hospital consensus statements, eight hospital resuscitation consensus statements, six system-level consensus statements, and six trauma registry consensus statements. The expert panel recommended six pre-hospital interventions, four hospital resuscitation interventions, nine system-level interventions, and seven trauma registry interventions applicable to the Indian context. Of these, 14 interventions were ranked as low cost/low difficulty, five high cost/low difficulty, five low cost/high difficulty, and three high cost/high difficulty. Interpretation & conclusions This consensus underscores the urgent need for integrated and efficient trauma systems to reduce preventable mortality, emphasizing the importance of comprehensive care that includes community engagement and robust pre-hospital and acute hospital trauma care pathways. It highlights the critical role of inclusive, system-wide approaches, from enhancing pre-hospital care and in-hospital resuscitation to implementing effective trauma registries to improve outcomes and streamline care across contexts.

This study aims to conduct a comprehensive global needs assessment to identify the prevailing conditions, specific needs, and challenges faced by surgical trainees and educators across diverse healthcare contexts. An international survey was developed and disseminated to surgical trainees and educators in 50 countries. The survey included sections on demographics, barriers to surgical education, educational activities, and training methods. Descriptive statistical analysis was performed on the responses, categorized into geographical regions: East Asia, South Asia, Africa, Europe and the Middle East, Latin America, and US and Canada. A total of 1262 responses were collected: 515 from trainees and 747 from educators across 50 countries. Among trainees, key barriers included a lack of access to simulation resources, insufficient protected time for education, and limited hands-on surgical experience, particularly in East Asia and South Asia. In these regions, trainees reported working long hours with minimal exposure to simulation-based training. For educators, significant challenges included the lack of dedicated educational budgets, insufficient protected time for teaching, and a lack of formal training in educational methodologies. Despite these obstacles, there was a strong global interest among educators in improving their teaching skills. This global needs assessment of surgical trainees and educators revealed critical gaps in surgical training, including limited access to simulation training and insufficient support for educators, particularly in developing regions. Addressing these disparities by expanding simulation resources and offering formal training for educators is essential for improving the training of surgical trainees globally.

Background: The patient satisfaction study is an important and commonly used valid indicator for service quality improvement in healthcare institutions. The aim of this study was to assess the service utilization and patient satisfaction in patients admitted under surgical service in Bir Hospital. Methods: A prospective cross sectional analytical study was conducted in Bir Hospital, National Academy of Medical Sciences from February 2021 till June 2023. The patient satisfaction data was collected using the SAPS scale after obtaining ethical clearance from the Institutional Review Board. Data were entered and analyzed in Statistical Package for the Social Sciences version 20.0. Results: There were 152 patients included in the study categorized into conservative treatment group, elective surgery group and emergency surgery group. 32.9%(50) patients were “very satisfied”, 62.5%(95) patients were “satisfied”, 2.6%(4) were “neither satisfied nor dissatisfied” and 2%(3) were “dissatisfied” with the effect of their treatment/care. The mean satisfaction score in conservative treatment group was 22.13 ±2.53 as compared to the mean satisfaction in elective surgery group which was 21.11± 2.55 (P=0.036) and the mean satisfaction score in emergency surgery group which was 21.66 ±2.68 (P=0.64). Conclusions: The mean score and proportion of patient satisfaction regarding service utilization in patients admitted under surgical service were high with satisfaction score higher in emergency surgery group among the operative groups in Bir Hospital, National Academy of Medical Sciences. Keywords: Patient satisfaction; service utilization; surgical service.

Introduction: Breast cancers are a varied group of lesions that differ in how they appear microscopically and how they behave biologically. There are two main types: in situ carcinomas and invasive breast carcinomas. In situ carcinomas refer to potentially malignant cells that grow within the beast but there is no evidence of spread in the nearby tissueswhen seen in routine microscopic examinations. Two types ofin situ carcinomasare recognized;acommon form is ductal carcinoma in situ (DCIS) and the less common form is lobular carcinoma in situ (LCIS). Objectives: This study aims to assess the prole of breast cancers, identied breast lumps at the undergoing histopathological evaluation, clinical ndings and radiological reports with the patient surgical intervention, biopsy method (FNA, core needle, surgical and mastectomy) at the Department of Pathology in NAMS, Bir Hospital. General Objective: To nd the histopathological characteristics of breast cancer undergoing surgical intervention and evaluation at Bir Hospital, NAMS.. Specic Objective: Types of biopsy methods (FNA, core needle, surgical and mastectomy) used to obtain the samples from the patients with breast diseases. Proportion of inammatory, benign, and malignant breast diseases among the patients with breast diseases. And hence, metastatic breast cancer among the patients with breast diseases. Methods: This study design is a cross sectional descriptive type of study. Data collected from the histopathological records of 5 years between 14 April 2019 - 13 April 2024. Types of biopsy methods (FNA, core needle biopsy, surgical biopsy and mastectomy), collected from the Department of Pathology. Result: The diagnosis process of pathological ndings, among 232 breast patients, 33 patients had undergone FNAC, 44 patients did Core needle biopsy, 60 patients surgical biopsy and 95 mastectomy. Among them, patients are classied into three breast diseases as per ndings; Inammatory (n=81), Benign (n=36), and Malignant (n=115). As seen, prime patients were in their 40s. Among 232, 68 and 164 patients had metastatic and non-metastatic breast cancers. Wherein, male pt. 2.58% , females pt. 97.41%. Ductal and lobular carcinoma in situ together included 3% of the total distinguished histopathological characters of breast cancer, whereas, remaining were classied in invasive breast carcinoma (NST). Conclusion: Establishing the breast pathology Invasive breast carcinoma (NST) is the major case. Age groups of 31-60 years patientswereinvolvedmorethanotheragegroups.

A workforce trained in the development and delivery of equitable surgical care is critical in reducing the global burden of surgical disease. Academic global surgery aims to address the present inequities through collaborative partnerships that foster research, education, advocacy and training to support and increase the surgical capacity in settings with limited resources. Barriers include a deficiency of resources, personnel, equipment, and funding, a lack of communication, and geographical challenges. Multi-level partnerships remain fundamental; these types of partnerships include a wide range of trainees, professionals, institutions, and nations, yet care must be taken to avoid falling into the trap of surgical "voluntourism" and undermining the expertise and practice of long-standing frontline providers. Academic global surgery has the benefit of developing a community of surgeons who possess the tools needed to collaborate on individual, institutional, and international levels to address inequities in surgery that are spread variously across the globe. However, challenges for surgeons pursuing a career in global surgery include balancing clinical responsibilities while integrating global surgery as a career during training. This is due in part to the lack of mentorship, research time, grant funding, support to attend conferences, and a limitation of resources, all of which are significantly more pronounced for surgeons from low-resource countries.

Goal orientation is an important psychological construct which describes the nature of an individual’s intrinsic motivation for learning in terms of mastery and performance. Research on goal orientation in primary school through college-level learners has consistently demonstrated a relationship between goal orientation and learning outcomes, test scores, motivation, feedback incorporation and burnout. The aim of this study was to create and validate a novel instrument to measure goal orientation motivation in surgical trainees. A validation study of a novel survey instrument specific for surgical trainees was conducted at five general surgery training programs across the United States over the course of a single academic year. A 14 item goal orientation in surgical trainees (GO-ST) instrument was developed and responses were scored on a 5-point Likert scale measuring frequency over a month. Exploratory and confirmatory factor analyses were performed. A total of 144 residents participated for an 87.8% response rate. Confirmatory factory analysis using 3 domains yielded a final instrument with ten total questions. The Comparative Fit index (CFI) of this model was 0.950, the Goodness of Fit index (GFI) was 0.920, and the Standardized Root Mean Square Residual (SRMR) was 0.064. Using the goal orientation theory of motivation, The GO-ST instrument was successfully developed to measure the three domains of goal orientation, mastery, performance approach, and performance avoid in surgical trainees. The ability to distinguish the way in which a learner internalizes educational opportunities in terms of motivation paves the way to understanding a new perspective on wellness, mastery and the clinical learning environment.

PURPOSE: Achievement goal orientation (GO) theory describes Mastery (M), one's intrinsic drive for competency for the sake of competency, and performance approach (PAP), a drive for competency by displaying competency, which are both adaptive. In learners motivated by performance avoid (PAV), showing competency by avoiding appearing incompetent dominates (maladaptive). The aim of this study was to determine differences in GO by gender and training (PGY) level. METHODS: A prospective, multi-institutional cohort of general surgery trainees participated in a cross-sectional study (2020-2021). Participants completed a 10-item instrument (the Goal Orientation in Surgical Trainees, GO-ST) measured on a 5-pointLikert scale (1 = never,3 = weekly,5 = daily). Student's t-tests and ANOVA F-test were used as appropriate. RESULTS: A total of 144/164 trainees participated (87.8%). The sample was 40.0%(n = 56) female and 57.9%(n = 81) male; 21.3%(n = 30) were PGY1, 22.0% (n = 31) PGY2, 24.8%(n = 35) PGY3, 18.4%(n = 26) PGY4, 13.5%(n = 19) PGY5. There were no significant differences in mean scale scores by gender for Mastery (3.3 vs 3.5; p = 0.17), or PAP (3.7 vs 3.5; p = 0.10), but mean PAV scores were significantly higher for females (3.6 vs 3.3; p = 0.04). While there were no significant differences in mean Mastery and PAP scale scores by training level (p = 0.44; p = 0.31), there was a significant difference in PAV scores (p < 0.01). The frequency of PAV feelings decreased over 5 years. CONCLUSIONS: Only PAV motivation differed by gender and training level. Understanding the psychology of motivation with this framework can aid both residents and programs in re-focusing on more adaptive learning strategies and supporting trainees in their transition to master surgeons. (C) 2022 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Intro An individual’s intrinsic learning motivation tendencies are a potentially modifiable factor. One of the three domains of goal orientation (GO) motivation is performance avoid (PAV), or a sense of achievement based on avoiding a negative outcome. PAV has been associated with burnout in non-medical populations. The aim of this study was to determine correlations between perceived stress and aspects of burnout with domains of GO. Methods A multi-institutional cross-sectional study of general surgery trainees at five training programs was performed. Residents completed a questionnaire consisting of the Goal Orientation in Surgical Trainees (GO-ST) scale, the abbreviated Maslach burnout inventory (aMaslach) and the Perceived Stress scale (PSS). GO-ST is a ten-item instrument which measures frequency of feelings over the past month on a 5-point Likert scale. Pearson correlation coefficients were calculated between each domain of the GO-ST (Mastery, Performance Approach and PAV, the PSS and aMaslach scales, as well as between the GO-ST domain and individual PSS and aMaslach questions. Results There were a total of 144 respondents (response rate 87.8%). The mean age of participants was 30.3 (SD 2.9) years. The mean frequency of PAV feelings was 3.5 (SD 0.83; slightly more than weekly), mastery was 3.4 (SD 0.75) and approach 3.6 (SD 0.80). Higher PAV scale scores were positively correlated with stress (0. 49, 95% CI 0.36, 0.61) and emotional exhaustion (0.40, 95% CI 0.24, 0.53). Performance Approach (PAP) was slightly more weakly correlated with stress (0.38, 95% CI 0.22, 0.52). The Mastery domain was correlated with a sense of accomplishment (0.46, 95% CI 0.32, 0.59). Conclusions In a large cohort of general surgery residents, performance-avoid motivational behavior is correlated with emotional exhaustion and stress, while mastery is correlated with personal accomplishment. Avoid-type feelings are as pervasive as mastery feelings. Residents and programs may benefit from this new approach to understanding elements of burnout, as goal orientation represents a potentially modifiable aspect of an individual’s achievement thought processes and measure of the learning environment.

Mass Casualty Incidents (MCIs) represent events where the number of patients arriving in a short time period is too great for the capabilities of local resources to manage [1]. Examples of MCIs include natural disasters (floods, earthquakes, tornadoes), multi-vehicle collisions, explosions, structure fires, terrorist attacks, and other acts of violence. While data regarding the nationwide prevalence of MCIs is sparse, a study utilizing the 2010 National Emergency Medical Service(EMS) Database reported a total of 14,504 EMS responses designated as MCIs representing 9913 unique incidents over a 1-year period [2]. In addition, deaths and injuries from mass shootings have increased from 11 in 2010 to 704 in 2017, according to data from the Mother Jones Project, and there were 315 natural disasters causing 11,804 deaths in 2018 alone [3, 4]. It is therefore reasonable to assume that hospital systems throughout the United States will continue to face MCIs in the future. Any event which generates a large number of patients over a short period of time can not only overwhelm the local healthcare system, but also disrupt the normal conduct of Graduate Medical Education (GME) programs. [5, 6] Given the structure of hospital systems and postgraduate training programs, residents are likely to comprise an important component of the frontline response to an MCI [7].For example, residents in New Orleans in 2005 were faced with managing patients independently following Hurricane Katrina, surgical residents responded to patients injured in the Boston Marathon bombing, and general surgery residents were called upon to treat multiply injured patients after a 2016 mass shooting in Orlando [6, 8, 9]. Involvement in caring for patients injured by an MCI can have a long-lasting impact on the healthcare team and healthcare infrastructure. While some of these effects resolve, such as the strain that multiple patients put on the healthcare workforce, the psychological impact on healthcare providers can persist long after the acute event. The intense pace of a surgical training program, combined with the hierarchical structure of the healthcare system makes residents particularly vulnerable to psychological distress that is unaddressed after an MCI. Up to 30% of residents, caring for patients after the Orlando nightclub shooting reported major stress, depression, and burnout 6 months after the event [10]. Despite the potential for profound effects on the residency training program and the mental health of involved residents, there is a scarcity of * Anip Joshi anipjoshi@yahoo.com

There has been a substantial impact on surgical education globally due to COVID-19 pandemic. The subtle and overt changes in surgical training programs during this pandemic along with its possible implications on the competence of future surgeons needs to be analyzed. If the essential measures are not taken in time, the surgical training programs are in a probable risk of failing to help surgery trainees successfully transition to the next phase of their surgical career. With a timely intervention for remediation, the surgery education programs will be sending surgical graduates into the community and society with the level of competency, expected from a surgeon despite COVID-19 pandemic. Keywords: COVID-19; surgical education; surgical simulation training.

BACKGROUND:There is a huge difference in the standard of surgical training in different countries around the world. The disparity is more obvious in the various models of surgical training in low- and middle-income countries (LMICs) compared to high-income countries. Although the global training model of surgeons is evolving from an apprenticeship model to a competency-based model with additional training using simulation, the training of surgeons in LMICs still lacks a standard pathway of training.METHODS:This is a qualitative, descriptive, and collaborative study conducted in six LMICs across Asia, Africa, and South America. The data were collected on the status of surgical education in these countries as per the guidelines designed for the ASSURED project along with plans for quality improvement in surgical education in these countries.RESULTS:The training model in these selected LMICs appears to be a hybrid of the standard models of surgical training. The training models were tailored to the country's need, but many fail to meet international standards. There are many areas identified that can be addressed in order to improve the quality of surgical education in these countries.CONCLUSIONS:Many areas need to be improved for a better quality of surgical training in LMICs. There is a need of financial, technical, and research support for the improvement in these models of surgical education in LMICs.

Antimicrobial stewardship (AMS) programs can decrease non-optimal use of antibiotics in hospital settings. There are limited data on AMS programs in burn and chronic wound centers in low- and middle-income countries (LMIC). A post-prescription review and feedback (PPRF) program was implemented in three hospitals in Nepal with a focus on wound and burn care. A total of 241 baseline and 236 post-intervention patient chart data were collected from three hospitals. There was a significant decrease in utilizing days of therapy per 1000 patient days (DOT/1000 PD) of penicillin (p = 0.02), aminoglycoside (p < 0.001), and cephalosporin (p = 0.04). Increases in DOT/1000 PD at post-intervention were significant for metronidazole (p < 0.001), quinolone (p = 0.01), and other antibiotics (p < 0.001). Changes in use of antibiotics varied across hospitals, e.g., cephalosporin use decreased significantly at Kirtipur Hospital (p < 0.001) and Pokhara Academy of Health Sciences (p = 0.02), but not at Kathmandu Model Hospital (p = 0.59). An independent review conducted by infectious disease specialists at the Henry Ford Health System revealed significant changes in antibiotic prescribing practices both overall and by hospital. There was a decrease in mean number of intravenous antibiotic days between baseline (10.1 (SD 8.8)) and post-intervention (8.8 (SD 6.5)) (t = 3.56; p < 0.001), but no difference for oral antibiotics. Compared to baseline, over the 6-month post-intervention period, we found an increase in justified use of antibiotics (p < 0.001), de-escalation (p < 0.001), accurate documentation (p < 0.001), and adherence to the study antibiotic prescribing guidelines at 72 h (p < 0.001) and after diagnoses (p < 0.001). The evaluation data presented provide evidence that PPRF training and program implementation can contribute to hospital-based antibiotic stewardship for wound and burn care in Nepal.

Abstract Background Data surrounding antibiotic stewardship (AMS) in burn and chronic wound centers in low- and middle-income countries (LMIC) are limited. Given the long-term nature of the wounds, increased risk of infection and the potential for further infections being treated with antibiotics, burn and chronic wound centers represent a unique opportunity for antimicrobial stewardship. Methods Three hospitals that maintain long-term burn or chronic wound wards were selected in two regions in Nepal. A post-prescription review and feedback program (PPRF) was instituted in these departments, and locally salient antibiotic practice guidelines were developed based on international and local standards by the research team and local experts. Chosen physicians at each facility were trained as master physician champions. Champions subsequently trained physicians in their wards and ensured that guidelines were followed by prescribing physicians. Baseline and post-intervention phases covered 5 months each during 2018–2019. During the post-intervention phase, physician champions reviewed antimicrobial use at 72 hours and made one of the three recommendations if the antibiotic course was deemed unjustified: changing the antibiotic, stopping the antibiotic course, or de-escalation of the antibiotic. Results 482 patients were enrolled throughout the duration of the study, with 241 patients in each of the baseline and post-intervention periods. The average length of stay was 8.0 days in baseline (range 3–48 days) vs. 6.4 days (range 3–70 days) during post-intervention. Between baseline and post-intervention, IV antibiotics decreased from 1,161 antibiotic-days per 1,000 patient-days (PD/1,000) to 1,137 PD/1,000. Oral antibiotics decreased from 101 PD/1,000 to 77 PD/1,000. In addition, cephalosporins decreased from 526 PD/1,000 to 474 PD/1,000, and aminoglycosides decreased from 264 PD/1,000 to 117 PD/1,000. Conclusion Appropriate antimicrobial use is vital in patients with a long length of stays in the hospital to reduce the development of multi-drug-resistant organisms. This intervention showed that a post-prescription review and feedback model can have impact in chronic wound and burn centers in Nepal and be further adapted for use in other LMIC. Disclosures All authors: No reported disclosures.

Background: The Roux-en-Y hepaticojejunostomy surgery provides the mainstay of treatment in cases of bile duct injury following cholecystectomy.The aim of this study is to assess the quality of life in patients who underwent surgical repair of bile duct injury following cholecystectomy. Methods: The prospective cross sectional study was conducted in Gastrointestinal Surgery Unit, Bir Hospital, National Academy of Medical Sciences. The cases of bile duct injury following cholecystectomy who underwent surgical repair from April 2013 to March 2018 were included. The data collection was done using SF-36 quality of life questionnaire tool.The study was conducted after ethical clearance from Institutional Review Board of National Academy of Medical Sciences. Results: There were 26 cases of referred bile duct injury admitted in gastrointestinal surgery department from 2013 April till 2018 March out of which 19 (73%) were included in the study.More than half of the patients had limitations in carrying out vigorous activities (as running or lifting heavy objects) and 5.2% had a lot of limitations in carrying our moderate activities (as moving a table).63.1% of the patients did not have any interference with social activities with family, friends, neighbors or social groups because of their physical health or emotional problems. Conclusions: The surgical repair of bile duct injury following laparoscopic cholecystectomy has an impact on ability to perform work or daily activities as a result of physical health. However, it has little impact on patient’s perception of general health and social activities. Keywords: Cholecystectomy; BDI; QoL.