Review Article-Bile duct injuries: Mechanism and prevention

Operative bile duct injury is one of the serious complications of hepato-biliary surgery. It is feared because of the substantial morbidity, occasional mortality, additional expenditure and frequent litigation that accompany it. With the introduction of laparoscopic cholecystectomy (LC) there was an increase in the incidence of such injuries and their pattern also changed to more complicated varieties. The popularity of LC and various percutaneous endoscopic procedures for bile duct pathologies have made the younger generation of surgeons less familiar with open cholecystectomy and open operative approaches to bile duct injuries. A review of the literature pertaining to the mechanism of bile duct injuries, during both open and LC, and the techniques of their prevention, was carried out by Medline search; with the aim of helping surgeons in optimising their efforts of preventing these tragic accidents