摘要：LAPAROSCOPIC CHOLECYSTECTOMY HAS QUICKLY BECOME THE OPTIMAL THERAPEUTICAL OPTIONIN THE CASE OF GALLBLADDER LITHIASIS BECAUSE OF HIS MINIMALLY INVASIVE TECHNIQUE,REDUCED POSTOPERATIVE PAIN, FASTER RECOVERY, SHORTER HOSPITALIZATION, AND AS A WHOLE,REDUCTION OF THE HOSPITALIZATION COSTS.WE STUDIED 3595 CASES OF LAPAROSCOPIC CHOLECYSTECTOMIES PERFORMED IN THE 4TH GENERALSURGERY CLINIC IN CRAIOVA BETWEEN 2001 AND 2015. OF THESE, IN THIS ARTICLE, WE DISCUSS CASESOF EXTRAHEPATIC BILE DUCTS INJURIES PRODUCED DURING LAPAROSCOPIC CHOLECYSTECTOMY.WE EXCLUDED FROM THE STUDY THE LESIONS PRODUCED DURING CLASSICAL CHOLECYSTECTOMYOR OTHER SURGICAL INTERVENTIONS INVOLVING ADJACENT ORGANS. IN THE FOLLOWING, WEPRESENT THE CAUSE OF THESE LESIONS, THE MOMENT OF RECOGNITION AND OUR WAY OF SOLVINGTHESE LESIONS.WE FOUND TWO LESIONS FROM A TYPE OF STRASBERG CLASSIFICATION, FIVE PUNCTUAL OR PARTIALINJURIES (D TYPE OF STRASBERG CLASSIFICATION )OF THE EXTRAHEPATIC BILIARY DUCTS AND SIXMAJOR LESIONS ( E TYPE OF THE SAME CLASSIFICATION).IN THE CASE OF MINOR LESIONS, EVEN IF THEY WERE RECOGNIZED POSTOPERATIVELY, LAPAROTOMYSHOULD BE AVOIDED AND ATTENTION SHOULD BE GIVEN TO CORRECT DIAGNOSIS OF THE TYPE OFLESION AND ITS LOCALIZATIONTHE COMPLETE LESIONS OF THE MAIN BILE DUCT NECESSARILY REQUIRE AN OPEN INTERVENTION,AND THE PROCEDURES USED MAY BE: END-TO-END SUTURE, WHETHER OR NOT PROTECTED BY ATUTOR TUBE OR BILIO-DIGESTIVE DERIVATIONS IF THE MAIN BILE DUCT’S DIAMETER PERMITS US (IFIT IS DILATED). THE USE OF HEPATICOJEJUNOSTOMY ON ROUX-EN-Y LOOP REPRESENTS THEFAVORITE APPROACH IN THE RE-ESTABLISHING OF BILIARY CONTINUITY.
