Nontraumatic perforation of the bile duct treated with laparoscopic surgery.

Nontraumatic perforation of the bile duct (NPB), which has also been reported as spontaneous perforation of the bile duct, is a disease in which spontaneous perforation occurs in the wall of the extrahepatic or intrahepatic duct without any traumatic or iatrogenic injury. Although NPB in adults is extremely rare, we have treated two such patients using a laparoscopic technique. Both cases presented with intra-abdominal abscesses associated with common bile duct stones, and laparoscopic surgery for those conditions was initially performed. During the procedure, NPB was identified in the right intrahepatic duct in one case and in the left intrahepatic duct in the other case. Laparoscopic surgery consisting of common bile duct exploration, T-tube placement, cholecystectomy, and abscess drainage was safely performed in both cases. Both patients eventually recovered without major complications. Although NBP is an uncommon disease, it can be treated successfully with a laparoscopic procedure.