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Abstract
Phillpe Mouret, Jacques Perisat and Francois Dubois described their method of laparoscopic surgery in 1987. In 1988, a team of surgeons consisting of Eddie Reddick, William Saye, Barry Mekernan and Douglas Olsen performed the first laparoscopic cholecystectomy in the United States.
The universal implementation of laparoscopic cholecystec-tomy has brought significant advantages of shorter hospital stay, decreased postoperative morbidity and mortality rates and a quicker return to normal activity for patients with gall stone disease.
Bile duct injury is one of the most serious complications associated with gall bladder surgery. Common bile duct injuries occur in 0.2% to 0.5% of open cholecystectomy. The incidence of such injuries with laparoscopic cholecystectomy ranges from 0.2% to 3% in the literature.
The higher incidence of bile duct injuries seen with laparoscopic cholecystectomy is related to the steep learning curve with the procedure.
There are several intra-operative features indicate possible bile duct injury such as: Drainage of bile from any location other than a lacerated gall bladder and bile drainage from a tubular structures.
The postoperative features of bile duct injury include: Abdominal pains, distention, ileus, nausea with occasional fever and leucocytosis or persistent biliary drainage from a surgical drain. Patients with evidence of a biliary fistula or jaundice should have an imaging study to look for fluid in the abdomen either an ultrasound or preferably an abdominal CT scan.