Management of surgical complications

During the past three decades, major changes have occurred in the management of common bile duct (CBD) stones. For many years, open CBD exploration was the gold standard for managing choledocholithiasis. However, the advent of endoscopy and minimally invasive surgery, with considerably lower morbidity and mortality, has replaced open surgery as first-line treatment. Nevertheless, an understanding of the potential complications is essential for treatment planning and postoperative care. The most common complications of laparoscopic and open approaches to CBD exploration are retained and recurrent CBD stones, bile leak, bile duct injury, abscess/cholangitis, and pancreatitis. This chapter reviews these potential complications of and discusses the management of major intraoperative, postoperative, and delayed complications related to surgical treatment of CBD stones.