A REVIEW OF THE MANAGEMENT OF IATROGENIC BILE-DUCT INJURIES

Injuries to the extrahepatic biliary tree occurring during cholecystec tomy or other upper gastrointestinal surgical procedures are not uncom mon. The consequences are often catastrophic. We report the results of a personal series of bile duct repairs from a tertiary referral centr e over a twenty-one year period. A total of 33 patients were referred. Percutaneous transhepatic cholangiography was the radiological invest igation of choice to outline the biliary system. Percutaneous transhep atic dilatation was performed in six patients and 22 patients had eith er primary surgical repair, or reconstruction of their biliary tree pe rformed by hepaticojejunostomy with an 80cm Roux-en-Y limb. Of these o nly two have required revision surgery. We recommend early referral of patients with recognised iatrogenic injuries to specialist hepatobili ary units with no attempt at repair prior to referral.