Presenter: Gabriel Rangel-Olvera MD, MSc | Hospital General "Dr. Manuel Gea Gonzalez" Background: The post-cholecystectomy bile duct injury (BDI) is a life threatening condition, where severe cases require surgical intervention with a bilioenteric reconstruction. The results from minimally invasive (MI) approaches for the BDI repair studies have proven short term safety and feasibility; however they lack of middle long term follow-ups. The aim of the study is to show the patency and follow-up after 5 years of MI BDI repair. Methods: This is a retrospective comparative study of our prospectively collected database of patients with BDI who underwent robotic or laparoscopic hepaticojejunostomy; demographic and surgical variables were collected. Follow-up medical appointments were made at one month, three months, six months, 1 year, and then every year. At each appointment patency evaluation was done by evaluating the patient general condition, signs of cholangitis, stenosis, liver function tests and other postoperative complications. Results: Forty-six bile duct repairs(37, 80.43% by laparoscopic and 9, 19.57% by robotic-assisted approach) treated from June of 2012 to February of 2016 that have completed at least 5 year follow-up were evaluated. 37(80.43%) were female and 9(19.57%) male, the mean age was 41.28(19-77). The types of BDI were as follow: E1 (3,6.52%), E2 (11,23.91%), E3 (17,36.96%), E4 (12,26.09%) and E5 (3,6.52%); dividing the BDI by severity 31(67.39%) were Grade 2 and 15(32.61%) were Grade 3; also 11(23.91%) presented arterial injury and 4(8.7%) bilioenteric fistula (3 to the duodenum and one to the colon). All patients achieved the primary patency after the 90 days of the index treatment; during the follow-up. Three patients lost their primary patency, two of them requiring endoscopic intervention and 1 surgical re-intervention; achieving secondary patency after this intervention and maintaining this condition during the rest of the follow-up. Conclusion: The present study demonstrates good long-term results of bile duct injury reconstructions using laparoscopic and robotic surgery. These approaches are safe and effective alternative giving the benefits of MIS even in this complex entity.