الفهرس 
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Abstract
Bile duct injury is a serious complication after cholecystectomy and it has been increased by two folds with introduction of laparoscopic cholecystectomy.
The most common mechanism of bile duct injuries called the “classic injury”, is the misidentification between the cystic duct and the common bile duct during the surgical dissection of Calot’s triangle .
This injury is associated with the resection of a portion of the common bile duct and is usually combined with a right hepatic arterial injury. This type of injury was encountered in 67% of bile duct injury during laparoscopic cholecystectomy.
Most patients with post cholecystectomy biliary injuries, if not diagnosed at operation, present early in the postoperative period.
After open cholecystectomy , only about 10% of injuries are suspected after the first week, but nearly 70% are diagnosed within the first six months after operation.
Patients with bile duct injury present early within days by jaundice & progressive abnormal liver function tests & present lately within months to years by manifestations of cholangitis.
Patients may present with complications as secondary biliary cirrhosis, portal hypertension and ascitis.
Successful management of patients with postcholecystectomy bile duct injuries requires careful planning, thorough investigations and patient preparation before any intervention.
Investigations are used to diagnose bile duct injury entitled: Laboratory investigations, such as serum bilirubin, alkaline phosphatase and liver enzymes, radiological investigations, such as abdominal ultra sound, ERCP, CT, MRCP and isotopic scanning techniques,
Treatment of bile duct injury includes surgical and endoscopic techniques and the goal of surgical reconstruction is to do patent anastomosis to allow good bile flow to the alimentary tract.
Surgical repair includes end to end repair, hepatico-jejunostomy, repair of proximal biliary injuries and mucosal graft.
Endoscopic dilatation with insertion of biliary stent during ERCP is the most frequently used non-surgical method in the treatment of biliary duct.