[Bile duct injuries due to unwarranted duct catheterization during cholangiography (prevention and treatment)]

Attention is drawn to bile duct injuries resulting from unwarranted duct catheterism during cholangiography both for a presumed cystic duct, which turns out not to be one, and for a true cystic duct downstream of an aberrant duct which unfortunately is only detected later. The importance is stressed of access to the cystic duct after cautious dissection, extended to the gallbladder, has detected it up to the vent and ruled out the existence of an aberrant duct. There are several potential options available for the treatment of such ductal lesions, analysing their impact on the parenchyma. The surgeon should not entrust the patient's safety solely to the contribution of cholangiography. Recognition of mistreatment may come too late for effective remedial measures to be taken, particularly in those injuries which are not amenable to conservative treatment.