INJURY TO BILE-DUCTS DURING OPERATION

The uathors had 51 patients with iatrogenic injuries to the bile ducts . This complication occurred most frequently in cholecystectomy (45 pa tients). The injury was localized in the distal segment of the supradu odenal part of the hepaticocholedochus in 11, at the junction of the c ystic and hepatic ducts in 15, and in the region of the opening of the hepatic ducts in 23 patients; the lobar hepatic ducts were injured in 2 patients. Injury to the bile ducts was recognized during the first operative intervention in 13 patients, in 8 of them restorative operat ions could be performed. After the first operation peritonitis develop ed in 2, obstructive jaundice in 16, a complete external biliary fistu la in 14, and obstructive jaundice and an incomplete external biliary fistula in 6 patients. The biliary tract was reconstructed in all of t hem by forming a bilio-digestive anastomosis with au isolated ejunal l oop after Roux. The authors prefer using a changeable transhepatic dra in. Six patients died in the early postoperative period.