Abstract
As laparoscopic cholecystectomy (LC) has become widely practiced, intraoperative bile duct injury associated with this new technique is being realized. In this paper, six patients (2 were in our hospital and 4 were in other hospitals) who sustained bile duct injury were reviewed. Total eight injury sites in these patients were devided into 2 types. Five places (62.5%) of bile duct injury occurred at the proximal bile duct (left hepatic duct-1, right hepatic duct-2, bifurcation of hepatic ducts-2). Furthermore, right hepatic arterial injury was combined in this type and postoperative hepatic damage followed. While, three places (37.5%) of bile duct injury occurred at the distal bile duct (common hepatic duct-2, the division of cystic duct-1). The incidence of proximal type of injury in LC was more frequent than that (14%) in open cholecystectomy. Most of bile duct injuries in LC happened by misidentification of common hepatic duct for cystic duct. LC can be performed safely, and it can be associated with life-threatening complication such as bile duct injury. In order to prevent bile duct injury, proper patient selection, meticulous technique and an accepting attitude toward conversion to open cholecystectomy should be needed.
