Abstract
In a recent one decade (1981-1990) 14 cases of intraoperative biliary injury were experienced at the department, and 6 of them had the injuries at another hospitals. Almost all cases were operated on for the causative disease of gall stones, including common bile duct stones. Intraoperative biliary injury occurred in a frequency of 1.04% in the department. Most common cause of the injury was severe inflammatory adhesion in 9 cases, followed by operative technique in 3, and bile duct anomaly in 2. The site of injury involved the common bile duct in 5 cases, common hepatic duct in 4, junction of biliary tracts in 2, accessory hepato-biliary duct in 2 and cystic duct in one. The repair of the injury was performed intraoperatively in 8 cases, and post-operatively in 6 cases. In respect of operative methods of repair, anastomic stenosis developed in 2 (66.7%) of 3 cases undergoing end-to-end anastomosis of the bile duct and in 2 (28.6%) of 7 cases undergoing choledochojejunostomy. Judging from our experience with the period of presence of stricture, grade of inflammation and method of anastomosis, it was suggested that choledochojejunostomy was superior to end-to-end anastomosis of bile duct.
