title: [A survey of bile duct injuries sustained during laparoscopic cholecystectomy].
abstract: OBJECTIVE
  To summarize the reasons for bile duct injury (BDI) after laparoscopic cholecystectomy (LC), and to determine the effect of multiple treatment after BDI.
  
  
  METHODS
  A retrospective cohort study was performed. The medical records of 110 patients diagnosed with BDI after LC from October 1993 to November 2007, in ten large hospitals in Guangdong of China, were reviewed.
  
  
  RESULTS
  Among 110 patients with BDI, 58 cases (52.7%) were local patients, whereas 52 cases (47.3%) were transferred from outside hospitals. Reasons for BDI following LC were: (1) Lack of experience of the LC operator (48.2%); (2) LC performed during acute cholecystitis (20.0%); (3) The structure of Calot triangle was unclear (15.5%); (4) Variable anatomical position (11.8%); (5) Intra-operation bleeding (4.5%). The commonest sites of injury were the choledochus and common hepatic duct (76.4%). Following BDI, endoscopic stenting or operative repair was performed in 106 patients. The overall success rate was 95.3% (101/106), with a mortality rate was 0.9% (1/106). Cholangitis occurred in 3.8% (4/106) cases. Choledocho-enterostomy operation was performed in almost 60.0% (63/106) cases, and the success rate was 93.7% (59/63). Endoscopic stenting or operative repair was performed immediately following BDI in 23.6% (25/106) patients, the success rate was 100%; and within 30 days in 63.2% (67/106) patients. Eighty-eight out of 106 patients who underwent repair were successful following the first operative procedure.
  
  
  CONCLUSIONS
  Factors such as an un-experienced operator and unclear anatomical position were causes of BDI following LC. Early operative repair should be regarded as the treatment of choice, in patients diagnosed with BDI. Early refer to an experienced hepatobiliary operator ensures a high success rate.
authors.affiliation: Department of Hepato-biliary Surgery, the Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.
authors.forename: Ya-jin
authors.initials: YJ
authors.lastname: Chen
authors.forename: Bao-gang
authors.initials: BG
authors.lastname: Peng
authors.forename: Li-jian
authors.initials: LJ
authors.lastname: Liang
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.forename: Jin-rui
authors.initials: JR
authors.lastname: Ou
authors.forename: Zhi-xiang
authors.initials: ZX
authors.lastname: Jian
authors.forename: Feng
authors.initials: F
authors.lastname: Huo
authors.forename: Jie
authors.initials: J
authors.lastname: Zhou
authors.forename: Zuo-jun
authors.initials: ZJ
authors.lastname: Zhen
authors.forename: Xiao-fang
authors.initials: XF
authors.lastname: Yu
authors.forename: Mei-hai
authors.initials: MH
authors.lastname: Deng
authors.forename: Zhi-jian
authors.initials: ZJ
authors.lastname: Tan
authors.forename: Zong-hai
authors.initials: ZH
authors.lastname: Huang
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies