To investigate the experience of diagnosis and treatment of iatrogenic bile duct injury (IBDI).

Clinical data of 2 patients with IBDI who underwent hepatectomy in the People's Hospital of Xinjiang Uygur Autonomous Region between January 2016 and April 2017 were retrospectively analyzed. Case 1 was a 62-year-old female, presented with fever and jaundice 3 d after laparoscopic cholecystectomy (LC). Case 2 was a 44-year-old female, presented with yellow skin and mucosa 3 d after LC. Both patients were diagnosed with obstructive jaundice and IBDI. The informed consents of two patients were obtained and the local ethical committee approval was received.

Case 1 underwent ultrasound-guided transhepatic biliary drainage, and suffered from abdominal pain, abdominal distension and anorexia 1 month later. Computed tomography (CT) scan revealed multiple intrahepatic hypodense lesions, which were considered as liver abscess. Right hemihepatectomy combined with intrahepatic cholangiojejunostomy was performed in Case 1. Case 2 underwent exploratory laparotomy and cholangiojejunostomy after well preoperative preparations. The patient suffered from fever after 2 month. CT scan revealed liver abscess, CT angiography (CTA) revealed a pseudoaneurysm in the right hepatic artery. After multi-disciplinary consultation, right hemihepatectomy combined with left hepaticojejunostomy was performed. Two patients recovered well. No significant complication was observed in the patients during the 6-month follow-up after discharged from hospital.

For IDBI patients, CTA should be performed to check if complication of right hepatic artery injury exists. Revascularization should be performed timely. If it cannot be revascularized, bile duct repairing and right hemihepatectomy can be performed simultaneously. For patients with right hepatic artery injury which cannot be revascularized, postoperative conditions should be closely observed. Right hemihepatectomy should be performed timely when necrosis and liver abscess are detected in the right lobe.