الفهرس 
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Abstract
In this study, 15 patients with post cholecystectomy bile duct injuries were assessed, 11 of which were females and 4 males. The ages of the patients ranged between 20 and 65 years. Three patients were diagnosed intra-operatively while 12 patients were diagnosed in the post operative period.
The time of presentation of patients diagnosed post-operatively varied significantly among the patients ranging from a few days to 1 month. four patients presented clinically with obstructive jaundice. two patients presented with biliary peritonitis while four patients presented with external biliary fistulae and two patients presented with an intra abdominal collection (biloma).
All the patients were assessed through a thorough history taking and physical examination, in addition to complete laboratory work-up. Abdominal ultrasound was done as a routine primary investigation for all patients. It was very accurate in the detection of intrahepatic biliary dilatation and intraperitoneal collections and their aspiration.
ERCP was successfully performed as a preoperative investigative tool in all patients with accurate results documenting the level of bile duct injuries, also it was successful in management of some of these cases.
MRCP was done as a preoperative diagnostic tool for two patients. It showed excellent results in accurately specifying the level of the injury, and the degree of dilatation of the proximal biliary tree.
Management depended largely on time of diagnosis; The three patients diagnosed intra-operatively were managed immediately where two patients wih partial injury of the CBD was repaired primarily on a stent , the last one had an immediate hepaticojejunostomy performed to her.
Eight patients were managed non-surgically; two of them had urgent drainage laparotomy upon her presentation with biliary peritonitis, this was followed by ERCP sphincterotomy and stent insertion, two had US guided drainage of an intra abdominal collection of bile, this was followed by ERCP sphincterotomy and stent insertion .Four patients with bile leaks had ERCP sphincterotomy and stent insertion alone.Two of patients still biliary leakage post ERCP ; Roux-en Y hepaticojeujenostomy was done .
Four patients underwent elective surgical repair of their bile duct injuries. In this group patients had Roux-en Y hepaticojeujenostomies performed to them.
Short-term results were generally satisfactory. The short-term morbidity of the patients who underwent the operative procedures included. two patients developed a recurrent attack of cholangitis which resolved on conservative treatment. Another patient had a wound infection which was controlled by antibiotics. one case underwent second (re-do) attempt to treat a strictured simple loop hepaticojeujenostomy Most of the patients are under current follow-up.