Treatment of iatrogenic bile duct injury

Abstract

Endoscopic naso-gallbladder drainage can cause cystic duct damage. Serious iatrogenic bile duct injury is caused by surgical complications. The incidence of bile duct injury following laparoscopic cholecystectomy has been reported to be 0.5%. The Bismuth classification and Strasberg classification are used to classify the morphology of bile duct stenosis and bile duct injury, and can serve as an indicator of treatment. It has also been reported that iatrogenic bile duct injury at the hepatic hilum after cholecystectomy is accompanied by a high incidence of right hepatic artery injury and bile duct stenosis after biliary reconstruction. In cases with inflammation, identification of the anatomy is difficult. The first treatment for difficult cases should be limited to drainage only. Elective surgery should be considered after calming the inflammation, examining the extent of bile duct injury, and confirming whether or not there is damage to the hepatic artery. In addition, depending on the state of injury, early consultation with experienced hepato-biliary surgeons should be considered.