Abstract

AIM of the study was to analyse bile duct injuries (BDI): diagnostics, treatment methods and outcome after laparoscopic cholecystectomy (LC).

METHODS. Seventeen patients who sustained BDI after 1454 LC were treated in 2005- 2007 and analysed retrospectively according to the Amsterdam criteria.

RESULTS. Mild BDI, bile leakage from the minor bile ducts, occur red in 10 (0.7%) cases: in the treatment of biliomas, percutaneous drainage under US guidance was used inmost cases . In 4 cases endoscopic retrograde cholangiography and sphincterotomy (in 1 case also stenting) were performed. Long-term results after a median of 28 months were good or  excellent in all cases. There were 7 (0.5%) severe injuries. Four patients had major BDI with bile leakage and all of them were laparotomised: in one of them the injury was sutured and another underwent elective hepaticojejunostomy (HJS) 3 months later; 2 patients died following laparotomy. In 3 patients major bile duct transection was detected during LC and they underwent conversion and HJS. Two patients required repeat HJS later. Follow-up results for 5 patients following severe BDI after a median of 27 months are satisfactory (4 cases) and good (1 case).

CONCLUSION. It is important to avoid severe injuries because, as a rule, they require surgical treatment including repeat operations and may result in lethality.