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**23** 

*Poland* 

**Recontructive Biliary Surgery in the** 

Beata Jabłońska and Paweł Lampe *Medical University of Silesia in Katowice, Department of Digestive Tract Surgery* 

**Treatment of Iatrogenic Bile Duct Injuries** 

The aim of this chapter is to present different types of biliary reconstructions used in the

IBDI remain an important problem in gastrointestinal surgery. The most frequently, they are caused by laparoscopic cholecystectomy which is one of the commonest surgical procedure in the world. The early and proper diagnostics of IBDI is very important for surgeons and gastroenterologists, because unrecognized IBDI lead to serious complications such as biliary cirrhosis, hepatic failure and death. Choice of the proper treatment of IBDI is very important, because it may avoid these serious complications and improve quality of life in patients. Non-invasive, percutaneous radiological and endoscopic techniques are recommended as initial treatment of IBDI. When endoscopic treatment is not effective, surgical management is considered. The goal of surgical treatment is to reconstruct the proper bile flow to the alimentary tract. In order to achieve this goal, many techniques are used. There are contradictory reports on the effectiveness of bile duct reconstruction

The first descriptions of the anatomy of the liver and bile ducts originate 2000 years BC in Babylon. The presence of gallbladder stones were found in mummy priestess who lived in the eleventh century BC. Historical records derived from ancient Mesopotamia, Greece, Egypt and Rome, also demonstrate the presence of biliary tract diseases in those days. The first surgical procedures within the bile ducts were simple and uncomplicated. In 1618, Fabricus removed gallstones from the gallbladder. In 1867, Bobbs performed cholecystostomy. Cholecystostomy procedures were also performed by: Sims in 1878, Kocher in 1878 and Tait in 1879. The first planned cholecystectomy, performed on July 15, 1882, by the Berlin surgeon Langenbuch (1846-1901), was a breakthrough in the development of biliary surgery. In 1890, Couvoissier the performed the first choledochotomy. Development of operations performed on the bile ducts caused the the problem of iatrogenic bile duct injuries. In 1891, Sprengel, first described the case of bile duct injury. With the rise of this problem, the first reports of surgical reconstruction of the

surgical treatment of iatrogenic bile duct injuries (IBDI).

**2. Historical perspectives of reconstructive biliary surgery** 

**1. Introduction** 

methods in the literature.

Congress on Gastrointestinal Cancer, Barcelona, 2006." *Ann Oncol* 18 Suppl 7: vii1 vii10.

