Treatment options for iatrogenic bile duct injuries with the loss of confluence

Abstract

Iatrogenic bile duct injuries (IBDI) with the loss of confluence are the most feared types of biliary injury and represent 4% of all IBDI. The loss of confluence understood as when the right and the left hepatic ducts lose continuity with the common bile duct tree and to restore this continuity is a serious surgical challenge. Aim. The aim of this study is to share our results concerning the surgical treatment options of IBDI with the loss of confluence. Material and methods. During in a 10 years period (2008-2018) 105 patients with IBDI were admitted to our centers for surgical treatment. Among these patients there were only 13 patients with the loss of confluence (Strasberg E4 type).