Identification and Management of Bile Duct Injuries

Injury to the biliary system can be a major problem leading to significant morbidity for the patient. This most commonly occurs due to iatrogenic causes and identification as early as possible is critical to maximizing the patient outcome. The timing of identification will dictate the optimal time for repair, and this should be undertaken at a facility with hepatobiliary surgery expertise as well as advanced gastroenterology and interventional radiology services. Many biliary injuries can be managed through external drainage and/or endoscopic approaches, but significant injuries to major biliary structures will require operative repair, most often with a hepaticojejunostomy.