World Journal of Surgery

, Volume 25, Issue 10, pp 1360–1365

Surgical Therapy of Iatrogenic Lesions of Biliary Tract

Authors

  • Steven A. Ahrendt
    • Department of Surgery, The Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
  • Henry A. Pitt
    • Department of Surgery, The Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
Article

DOI: 10.1007/s00268-001-0124-2

Cite this article as:
Ahrendt, S. & Pitt, H. World J. Surg. (2001) 25: 1360. doi:10.1007/s00268-001-0124-2

Abstract.

Iatrogenic injuries of the biliary tract have increased in incidence over the past decade with the introduction of laparoscopic cholecystectomy. Although a number of factors have been identified with a higher risk of injury (male gender, complicated gallstone disease, aberrant anatomy) and a number of technical steps have been emphasized to avoid these injuries, the incidence of bile duct injuries has reached a steady-state at least double the rate observed with open cholecystectomy. Most patients sustaining a bile duct injury are recognized in the weeks following laparoscopic cholecystectomy. Careful preoperative preparation should include control of sepsis by draining any bile collections or fistulas and complete cholangiography. Long-term results are best achieved in specialized hepatobiliary centers performing biliary reconstruction with a Roux-en-Y hepaticojejunostomy. Success rates over 90% have been reported from several centers to date with intermediate follow-up.

Copyright information

© Société Internationale de Chirurgie 2001