TREATMENT OF BILE LEAKS FROM THE CYSTOHEPATIC DUCTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY

The cystohepatic ducts represent accessory bile ducts of variable size which frequently travel within the gallbladder fossa or in the poster ior wall of the gallbladder. These ducts can be injured during laparos copic cholecystectomy and can result in bile collections if transected . Successful treatment by operative means or radiologically guided per cutaneous drainage is possible, but endoscopic management has several advantages. We describe cases managed by endoscopic retrograde cholang iopancreatography (ERCP) with stent placement and discuss the advantag es of this method. Also discussed is the anatomy of these accessory bi le ducts, additional management options, and techniques for avoiding t his injury during open or closed cholecystectomy.