BILE-DUCT INJURIES IN LAPAROSCOPIC CHOLECYSTECTOMY

Injuries to the extrahepatic bile duct present a severe complication in laparoscopic cholecystectomy occuring in 0-2,6%. From June 1991 to September 1994 four patients were treated to the Department of Surgery at Bonn University with bile duct injuries after laparoscopic cholecystectomy. Ah had complete sections of the common bile duct. They were treated twice with a biliodigestive anastomosis and once by direct suturing of the d choledochus. One of our own patients suffered an injury of the right hepatic duct, most probably due to a thermic lesion. In all cases anatomy was irregular or unclear, To avoid these complications an intraoperative cholangiography should be performed in these situations. The reconstruction after inadvertent injuries of the bile duct depends on the localisation and the age of the lesion.