Bile Duct Injury

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Definition

Laparaoscopic cholecystectomy ( LC ) is the gold standard of treatement for symptomatic gall stones. It is a safe procedure, but rarely the bile duct gets injured during surgery. This complication occurs in 0.4% to 0.6 % of cases undergoing LC. If not managed properly this complication can be life threatening.

Diagnosis

The bile duct can get clipped or transected. If it is clipped patient will develop jaundice and sometimes fever, pain abdomen i.e.cholangitis. If the duct is transected bile will come into the abdominal cavity and may come out through the wound or drains. The patient needs to be stabilized in the acute setting, may require a drain placement either percutaneously/ radiologically or surgically.

The type of bile duct injury and extent is usually determined with a MRCP.

Treatment

Definitive treatment in most of the cases is Roux en Y Hepatico-Jejunostomy, which is a safe procedure and successful in the long term. Here a part of small intestine is connected to the healthy bile duct proximal to the injury or stricture.

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