Endoscopic approach to the patient with bile duct injury

Laparoscopic cholecystectomy (LC) is complicated by bile duct injury in 0.3% to 0.6% of cases. These injuries range from simple leaks from the cystic duct stump that can almost always be managed by endoscopic stenting to complex strictures, transections, and even resections of the bile duct, often with concomitant vascular damage leading to ischemia. The management of LC-related biliary injuries requires a multidisciplinary approach involving an endoscopist experienced in the use of ERCP, a skilled interventional radiologist, and a surgeon with specific training in the management of hepatobiliary injuries.