Treatment of bile duct injury in laparoscopic cholecystectomy

Abstract

Objective To explore the treatment methods of biliary tract injury in laparoscopic cholecystectomy (LC). Methods A retrospective analysis of eighteen cases with bile duct injury during LC from March 2003 to March 2017 in Kailuan General Hospital was conducted. There were 5 cases of needle like bile duct injury, 5 of injury less than 1/2 diameter of bile duct, 3 of injury more than 1/2 of common bile duct, complete transverse injury of bile duct, 3 of no tissue injury, 1 of total bile duct transection, left hepatic duct transection, right hepatic duct partial transverse injury, 1 of common bile duct injury, and 1 of tissue defect exceeding 2 cm. Results Of the 18 cases of bile duct injury, only one case with type Ⅵwas anastomosed with Roux-Y. Patients with type Ⅰ-Ⅴ were treated by simple repair or end-to-end anastomosis, T-tube support and adequate drainage to maintain normal biliary physiology. Through a median follow-up of 2.93 years, no serious complications or death were recovered. Conclusion Detection of bile duct injury, proper surgical approach and maintenance of biliary patency is key to good prognosis during LC. Key words: Cholecystectomy, laparoscopic; Biliary tract injury; Anastomosis, Roux-en-Y