Iatrogenic injuries to extrahepatic ducts and associated vessels: a twenty-five-year analysis.

From 1966 to 1981, there were 4,425 cholecystectomies at Saint Francis General Hospital and affiliated hospitals with a resultant iatrogenic injury rate of 6.3 percent. There were 279 intraoperative surgical accidents which involved injuries to the extrahepatic veins, arteries, and ducts. In addition, there were postoperative subdiaphragmatic collections of serum, bile, and/or blood. The mortality rate for these 279 injuries was zero but the morbidity was 32 percent. The ultimate success of the intraoperative phase of cholecystectomy depends upon the knowledge and experience of the surgeon, adequate lighting, retraction, and satisfactory anesthesia.