[Iatrogenic injuries of the bile ducts in laparoscopic cholecystectomy]

The authors draw attention to possible injuries of the bile duct during laparoscopic cholecystectomy. They present their own experience with the treatment of 15 patients with this damage between 1993 and 1995. In nine instances they performed first re-operations. Once insufficiency of the cystic duct was involved once a clamp on the common bile duct, seven times thermal damage of the bile duct and six times severing or resection of the bile duct. On these grounds a plastic operation of the bile duct on the endoprosthesis was made seven times, a high hilar anastomosis with a blind loop of the jejunum, as described by Roux, six times, once ligature of the cystic duct by an open approach and once ablation of the clamp from the bile duct. When an endoprosthesis is used, the authors recommended the long-term administration of deoxycholic acid derivatives. The reduced number of these injuries in 1995 at the clinic may, in the authors, opinion, be due to the fact that surgeons have acquired reasonable skill as regards the technique of thus operation.