Bile duct damage

The bile ducts are easily damaged at cholecystectomy or exploration of the common duct. During elective cholecystectomy, the incidence of damage is 0.1-0.2%., but only about 20% of duct injuries are recognised.

Complications include:

• stricture of the common bile duct
• unrecognised ligation or transection of the common bile duct which may cause a major biliary leak or increasing jaundice. This necessitates an urgent re-exploration.

All damage to the bile ducts generally necessitates reconstructive surgery, e.g. a hepatico- or choledochojejunostomy (Roux-en-Y). However, now the endoscopic placement of a stent offers the opportunity of treating a strictured duct without necessity of an open operation.