Early repair of iatrogenic bile duct injury caused by laparoscopic cholecystectomy

Abstract

Objective To study the characteristics, operative timing, repair methods for iatrogenic bile duct injury caused by laparoscopic cholecystectomy. Methods Clinical data of 30 cases of iatrogenic bile duct injury found during or after laparoscopic cholecystectomy were studied retrospectively . Results There were type Ⅱ1 bile duct injury in 9 patients, type Ⅱ2 in 4 patients, type Ⅱ3 in 2 patients, and type Ⅱ 4 in 15 patient. 17 cases underwent immediate repair, 13 cases did early repair. All cases followed up from 5 months to 10 years, the follow-up rate was 83.3%. 1 case with end-to-end anastomosis and biliary stent underwent Roux-en-Y choledochojejunostomy for biliary stenosis 13 months postoperatively, 4 cases underwent secondary Roux-en-Y choledochojejunostomy because of obstructive jaundice and the cicatricial anastomotic orifice stenosis one to one and half years after primary repairs. The remaining cases were doing well up to the end of the follow-up. Conclusion Most iatrogenic bile duct injury after laparoscopic cholecystectomy were high in position, while Roux-en-Y choledochojejunostomy is the mainstay of repair . Key words: Bile ducts; Wounds and injury; Postoperative complications; Choledochojejunostomy