Journal of Gastrointestinal Surgery

, Volume 21, Issue 8, pp 1368–1372 | Cite as

Laparoscopic Repair of Post-cholecystectomy Bile Duct Injury: an Advance in Surgical Management

  • Safi DokmakEmail author
  • Najat Amharar
  • Béatrice Aussilhou
  • François Cauchy
  • Alain Sauvanet
  • Jacques Belghiti
  • Olivier Soubrane
Multimedia Article


Despite widespread advances in laparoscopic surgery, laparoscopic repair of post-cholecystectomy bile duct injury (BDI) has rarely been reported related mainly to technical difficulty. We describe three cases of BDI treated laparoscopically with one illustrated by a video. With our gained experience in hepatic pedicle dissection during laparoscopic pancreaticoduodenectomy, we decided to perform laparoscopic repair of BDI in patients with an intact biliary confluence without vascular injury. Three patients were operated including two women: one was re-operated by subcostal incision for peritonitis and two had undergone cholecystectomy without conversion. Surgical technique is detailed in the manuscript and the video. Laparoscopic repair was performed between 45 and 300 days after cholecystectomy. Surgery lasted between 250 and 270 min with no conversion and no transfusion. The postoperative course was uneventful with a hospital stay ranging from 7 to 9 days. After a mean follow-up of 9–33 months, patients were symptom free with normal liver function tests. The laparoscopic approach can be safely and effectively proposed to a subgroup of patients with BDI. This approach has the advantages of the laparoscopic approach and represents the main new surgical advancement in the management of this complication.


Cholecystectomy Bile duct injury Laparoscopic repair Traumatism 



Bile duct injury


Biliary fistula


Compliance with Ethical Standards

The authors state that informed consent was obtained from all patients, and that the study protocol has been approved by the institute’s committee on human research.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

Video 1

(MP4 84,585 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  • Safi Dokmak
    • 1
    • 2
    Email author
  • Najat Amharar
    • 1
    • 2
  • Béatrice Aussilhou
    • 1
    • 2
  • François Cauchy
    • 1
    • 2
  • Alain Sauvanet
    • 1
    • 2
  • Jacques Belghiti
    • 1
    • 2
  • Olivier Soubrane
    • 1
    • 2
  1. 1.Department of HPB Surgery and Liver TransplantationBeaujon HospitalClichyFrance
  2. 2.Assistance Publique Hôpitaux de ParisUniversity Paris VII Denis DiderotParisFrance

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