[Treatment of bile ducts injuries after laparoscopic cholecystectomy]

Features of bile ducts injuries after laparoscopic cholecystectomy were analyzed at 54 patients. High level of lesions (H. Bismuth III-IV type) was revealed at 80% cases. Along with mechanical (transsection, excision, clipping) thermal injury of the bile ducts is usual at laparoscopic cholecystectomy. The injury was diagnosed during the operation at 21 (37.7%) cases, in 2-30 days after operation--at 30 (56.6%), and in 3 months--2 years--at 3 (5.7%) patients. Surgical tactics depended on level and terms of injury, state of bile duct wall and complications. Biliodigestive anastomosis with Roux techniques and transhepatic drainages was the main surgical method (76% cases). Peritonitis and other severe complications required two-stage treatment. Overall 40 (74.1%) patients followed-up more 3 years; there were no cases of stricture recurrence.