Mechanical and preventable factors of bile duct injuries during laparoscopic cholecystectomy.

Bile duct injury (BDI) occurring during cholecystectomy has been proposed as the most serious and important cause of morbidity after this procedure. A literature review was performed about the mechanical and preventable factors of bile duct injury listed on Medline databases. Although most injuries occur within the surgeon's first 100 laparoscopic cholecystectomies, it has been suggested that most general surgeons may encounter bile duct injuries. Several techniques have been proposed to avoid this injury. Sound knowledge of anatomy regarding the hepatobiliary system, good surgical skills, awareness of this problem, and referral to higher centres if injury ensues, seem to be the appropriate course of action towards prevention.