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.
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Ahrendt, S., Pitt, H. Surgical Therapy of Iatrogenic Lesions of Biliary Tract. World J. Surg. 25, 1360–1365 (2001). https://doi.org/10.1007/s00268-001-0124-2
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DOI: https://doi.org/10.1007/s00268-001-0124-2