Iatrogenic injury in videolaparoscopic cholecystectomy: Difficult surgicalcorrection biliary tract

Two cases of biliary tract serious lesions during videolaparoscopic cholecy stectomy are reported. In the first case of lithiasic cholecystitis there h ad been a complete damage of the common biliary duct; in the second case th ere had been a double main biliary duct binding with removal of a biliary t ract segment. In both cases a biliary confluence;jejunal anastomosis with R oux-en-Y loop was made up. In the first one the operation was difficult bec ause of the main bile duct's fragility and modest expansion. In the second one the presence of a secondary biliary duct in gallbladder fossa not recog nized, but drained outside with a common drainage placed during the operati on prevented appearance of jaundice with dilatation of biliary ducts. It wa s heavily conditioned performing confluence-jejunal anastomosis with Roux-e n-Y loop. The post-operative course was characterized by appearance of an external bi liary fistula which has spontaneously disappeared. One year later, neither of the two patients had any stenosis or cholangitis problems.