Treatment time and surgical method option in iatrogenic bile duct injury        TIAN Yu-lin. Department of Gastrointestinal Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Abstract    About 90% of iatrogenic bile duct injury is caused by cholecystectomy. Different treatment methods should be adopted according to finding time, the location and type. If it is found during operation and repaired immediately, the success rate is high and the long-term effect is good. If the drainage of postoperative bile leakage is smooth, condition changes should be observed for the further treatment. Patients with bile peritonitis need laparotomy. Bile duct and abdominal cavity drainage are usually performed at first, and then bile duct repairing. Obstructive jaundice should be observed until bile duct dilatation diameter ≥ 15mm, then the surgical repair of bile duct should be performed. Later bile duct scarring or anastomotic stricture should be treated by endoscopy, interventional or surgical method. The best option of bile duct repairing is to both restore biliary continuity and save the oddi sphincter function, such as with a vascular pedicle flap transplantation or bile duct anastomosis to the side and so on. If methods above are not suitable for the treatment of patients, bile duct jejunum Roux-en-Y anastomosis is a common and effective method.