Iatrogenic bile duct injuries: a clinical analysis of 64 cases        ZHOU Yong, LIU Jin-gang. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
Corresponding author: LIU Jin-gang, E-mail: liujg@sj-hospital.org
Abstract    Objective    To analyze and summarize the experiences of diagnosis and treatment for iatrogenic bile duct injury (IBDI). Methods    The clinical data of 64 cases of IBDI admitted between January 2005 and December 2009 in Shengjing Hospital of China Medical University were analyzed retrospectively. Results    Of all 64 cases, there were 41 cases occurred in opened bile ductal surgeries; 16 cases happened in laparoscopic cholecystectomies; 7 cases come up with other surgeries. Four cases injured with leakage of bile gently were drainage by ENBD. Five cases were found in the operation and undergone a T-tube drainage in the injured site. Other 55 cases were treated by Roux-en-Y anastomosis of bile duct and jejunum. One case died; 2 cases went through operation once again due to the stricture of the anastomotic stoma; 1 case experienced re-operation due to the defluvium of the stent tube. Sixty-three cases recovered smoothly and were followed-up over 12 months. Conclusion    On condition that gentle IBDI is found in the operation, it should take simple suturing and repairing into consideration modestly, but for a positive T-tube drainage. In case of complete truncation of the bile duct occurs in the operation, or the injury is found several days after the surgery or reconstruction surgery fails, Roux-en-Y anastomosis of bile duct and jejunum may be the first choice, which could lead a satisfactory curative effect, while the annular anastomat should be applied cautiously.