[Lesions of the bile ducts in open cholecystectomy]

The incidence of bile duct injuries during open cholecystectomy is around 2/1000. The most common lesion is complete divisions of the common bile duct, followed by partial divisions, stenoses or obstructions. The therapy of the lesions recognized intraoperatively is end-to-end anastomosis or, in the case of greater defects, hepaticojejunostomy. Strictures manifesting while after cholecystectomy can primarily be treated endoscopically, in divisions of obstructions hepaticojejunostomy is indicated; in high lesions the Hepp-Couinaud approach can be advocated.