Iatrogenic bile duct injuries in laparoscopic cholecystectomy: a contemporary review of epidemiology, diagnosis, and management with a clinical case of Roux-en-Y hepaticojejunostomy reconstruction

Laparoscopic cholecystectomy (LC) remains the «gold standard» for gallbladder diseases but carries a 0.4—1.5% risk of iatrogenic bile duct injuries (BDI). The article presents a review of randomized clinical trials (RCTs) published in open-access international peer-reviewed journals between 2015 and 2025. Data were extracted from electronic databases (PubMed, Scopus, Web of Science, eLibrary.ru, Cochrane Library) following the principles of evidence-based medicine. This review examines modern data on BDI risk factors (anatomical variations, inflammatory changes, surgeon experience), diagnostic methods (MRCP, ERCP, CT), and treatment algorithms, focusing on reconstructive techniques, including Roux-en-Y hepaticojejunostomy as the optimal approach for biliary strictures. A clinical case of a 68-year-old patient with post-LC common bile duct obstruction due to clip migration is presented. The diagnostic pathway (MRCP → ERCP → relaparoscopy) enabled precise injury localization and laparoscopic hepaticojejunostomy, resulting in normalized biochemical parameters (bilirubin: 26.6 µmol/L) and no complications. Key findings highlight the role of multidisciplinary management, early imaging, and minimally invasive reconstruction. Conclusions. MRCP is pivotal for non-invasive diagnosis, laparoscopic reconstruction remains effective for BDI, Roux-en-Y hepaticojejunostomy ensures long-term biliary decompression.