Prevention and Treatment of Bile Duct Injury in Laparoscopic Cholecystectomy / 中国普外基础与临床杂志

ABSTRACT

Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). Methods Latest progress was reviewed based on recent documents and the experience on BDI in LC in our department. Results With the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s over confidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, Roux en Y choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.