[Injury to the bile ducts during surgery]

The authors had 51 patients with iatrogenic injuries to the bile ducts. This complication occurred most frequently in cholecystectomy (45 patients). The injury was localized in the distal segment of the supraduodenal part of the hepaticocholedochus in 11, at the junction of the cystic and hepatic ducts in 15, and in the region of the opening of the hepatic ducts in 23 patients; the lobar hepatic ducts were injured in 2 patients. Injury to the bile ducts was recognized during the first operative intervention in 13 patients, in 8 of them restorative operations could be performed. After the first operation peritonitis developed in 2, obstructive jaundice in 16, a complete external biliary fistula in 14, and obstructive jaundice and an incomplete external biliary fistula in 6 patients. The biliary tract was reconstructed in all of them by forming a bilio-digestive anastomosis with an isolated jejunal loop after Roux. The authors prefer using a changeable transhepatic drain. Six patients died in the early postoperative period.