Introduction : Roux-en-Y choledocho-jejunostomy are most common reconstruction procedure for transected bile duct injuries during laparoscopic cholecystectomy. However, end to end reconstruction can be performed in selected patients. This report describes eight cases of laparoscopic end to end biliary reconstruction with T-tube for transected bile duct injury during laparoscopic cholecystectomy.

Methods : A retrospective descriptive analysis was performed for all patients with transected bile duct injury at a single institution between January 2014 and December 2017. Details of injury site and type, reconstruction methods, conversion rate and outcomes were collected and analyzed.

Results : Between January 2014 and December 2017, 2901 patients underwent laparoscopic cholecystectomy at a single institution. Among them, eight patients had transected bile duct injury during laparoscopic cholecystectomy. They underwent laparoscopic end to end biliary reconstruction with T-tube. The reported series consisted of 6 women (75%) and 2 men (25%) with a mean age of 48.3 years (range 29-77 years). Two cases were converted to open surgery. The most common injured type classified according to Bismuth’s classification was type I (3/8, 37.5%). The mean operating time was 136.8 min (range 0-180.0 min). The mean hospital stay was 7.0 days (range 3.0-21.0 days). The mean follow-up was 29.0 months (range 0-57.0 months). We have observed one postoperative complication during follow-up period, anastomosis site leakage cured by re-operation.

Conclusions : Laparoscopic end to end biliary reconstruction with T-tube for transected bile duct injury during laparoscopic cholecystectomy can be safe and feasible in selected patients, operated on by expert laparoscopic surgeon.