• P Puche, E Jacquet, F Borie, P E Colombo, H Bouyabrine, A Herrero, F Guillon, J P Carabalona, J M Fabre, B Millat, J Domergue, and F Navarro.
• Service Médico-Chirurgical des Maladies de l'Appareil Digestif et de Transplantation Hépatique, Hôpital Saint Eloi - Montpellier, France. p-puche@chu-montpellier.fr
• J Chir (Paris). 2007 Sep 1; 144 (5): 403-8.

UnlabelledBiliary injuries after laparoscopic cholecystectomy are rare but serious. Their mortality rate can reach 9%.Aim Of The StudyDescribe the management of biliary injuries after laparoscopic cholecystectomy in our center.PatientsBetween January 1995 and June 2005, 27 patients (13 women, 14 men) were treated. The mean age was 53 years old (range, 18-92 years). The biliary injuries were common bile duct sections (n=16, 60%), common bile duct stenoses (n=5, 18.5%), biliary fistulas from the cystic duct (n=4, 15%), and biliary fistulas from an aberrant biliary duct (n=2, 7.5%).ResultsAcute cholecystis was present in 40% of cases (n=11). An intraoperative cholangiography was done in 12 patients (44%). The mortality rate was 0%. Of the common bile duct sections, 43% were diagnosed during the cholecystectomy (n=7) or after the cholecystectomy within a mean of 11.2 days (n=9). Common bile duct injuries were treated in 16 cases with hepatojejunostomy and in five cases with an external biliary drain. Fistulas from the cystic duct were diagnosed within a mean 14.8 days. A fistula from an aberrant biliary duct was diagnosed during the cholecystectomy (n=1) or in the second postoperative day (n=1). Fistulas were treated with a clip on the cystic duct (n=2), an external biliary drain (n=1), a biliary endoprosthesis (n=1), and the biliary aberrant duct suture (n=2).ConclusionCommon bile duct injuries are a serious complication because their treatment is a hepaticojejunostomy in 75% of cases.

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