Devastating and Fatal Complications Associated With Combined Vascular and Bile Duct Injuries During Cholecystectomy

Abstract

BILE DUCT injuries are the most dreaded complication associated with either open or laparoscopic cholecystectomy. Initial experiences with laparoscopic cholecystectomy noted a dramatic rise in iatrogenic bile duct injuries.^1,2 This rise was first attributed to a significant learning curve. Despite the widespread application of the laparoscopic procedure, the incidence of iatrogenic injury has not declined. Instead, it has stabilized at a level higher than that experienced in open cholecystectomy.³ With recognition of this phenomenon, multiple series have been reported with incidence and management strategies for bile duct injuries. However, few groups have documented the incidence or clinical impact of combined vascular and biliary injuries in either open or laparoscopic cholecystectomy.^4,5