The Morbidity of Injuries of the Extra-hepatic Biliary System
Blunt and penetrating injuries of the extrahepatic biliary system are rare and appear to be increasing in frequency. The severe morbidity associated with these lesions is related to incomplete efforts at diagnosis and errors in therapeutic decisions. The morbidity may be minimized by: 1) a high index of suspicion and awareness of these lesions; 2) complete exploration of all hematomas around the bile ducts to reduce the incidence of overlooked injuries; 3) meticulous repair of tangential injuries; and 4) primary biliary-enteric diversion for complete transection of the ducts. A knowledge of the various options in operative management is crucial since unexpected injuries are not uncommon.