BILE-DUCT INJURIES IN LAPAROSCOPIC CHOLEC YSTECTOMY

Injuries to the extrahepatic bile duct present a severe complication i n laparoscopic cholecystectomy occuring in 0-2,6%. From June 1991 to S eptember 1994 four patients were treated to the Department of Surgery at Bonn University with bile duct injuries after laparoscopic cholecys tectomy. Ah had complete sections of the common bile duct. They were t reated twice with a biliodigestive anastomosis and once by direct sutu ring 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 a ll cases anatomy was irregular or unclear, To avoid these complication s an intraoperative cholangiography should be performed in these situa tions. The reconstruction after inadvertent injuries of the bile duct depends on the localisation and the age of the lesion.