Iatrogenic Lesions of the Bile Duct

Abstract

Introduction: the bile duct is an anatomical element of the human being and is a conduct that transports bile from the liver to the duodenum. Cholecystectomy is one of the most frequent surgical procedures in the world, and therefore the risk of injury to the bile duct. Objective: an exhaustive search of the national and international medical literature on iatrogenic bile duct injury and its variants in a medical and/or surgical setting. Discussion: laparoscopic cholecystectomy has reached at least twice the rate observed compared to open cholecystectomy. The term iatrogenesis is most often misinterpreted as medical malpractice. Iatrogenesis, according to the World Health Organization, is any harmful, unintentional, and unwanted effect that occurs during healthcare. Iatrogenic bile duct injury has catastrophic consequences because it requires reoperation, long-term follow-up, prolonged recovery, and unprecedented morbidity/mortality. The factors involved are the anatomical variants, the intense inflammatory process of the area, the hospital infrastructure and human expertise. Management can be endoscopic and/or surgical, which the latter is the main actor in reconstructions, such as hepatic-jejunum-anastomosis, hepatectomies, etc. Conclusions: cholecystectomy has a high risk of bile duct injury, its incidence is unknown in Mexico, morbidity is exponential and consequently mortality. Suspecting that it has become the most frequent surgical pathology. An iatrogenic injury to the bile duct is an Armageddon to the patient/health system due to its high morbidity and mortality, its long duration and its high cost.