Role for laparoscopy in the management of bile duct injuries

Abstract

Laparoscopic techniques can be used to avoid, diagnose and treat CBD injuries, and early evidence shows this can be safe. In the initial operation, subtotal cholecystectomy can be useful in avoiding injury where there is severe inflammation or obscure anatomy. A bile leak or fresh injury can be assessed at the index operation to help plan for immediate versus delayed repair. In the postoperative period, relaparoscopy can allow for identification of CBD injury, drainage of intra-abdominal collection, and exclusion of injury to surrounding structures, which can guide the decision between conservative management and early or late definitive repair.