The Significance of Biliary Anatomical Variation as a Key Indicator in Laparoscopic Bile Duct Injuries

Introduction: The science of Gastrointestinal (GI) endoscopy is the science and art of millimeters that has marvelously evolved over the past 30 years. Cholecystectomy, most of which is done laparoscopically, is one of the most common procedures performed today (approximately 750,000 cases are performed annually in the USA) and is considered relatively safe. However, laparoscopic cholecystectomy is associated with bile duct injuries. Several studies examining bile duct injuries have found significant rates of complication (0.39%---1.5%, that comes roughly to over 3,000 patient per year). Therefore, bile duct injuries are commonly encountered, and a clear understanding of the extensive variation in biliary anatomy is imperative to appropriately and successfully manage this common clinical problem to ultimately provide the highest level of patient care.