Laparoscopic Cholecystectomy-Induced Complex Common Bile Duct Injury: Will Rescue ERCP Help?

A 33-year-old woman presented for laparoscopic cholecystectomy (LC)-induced accidental transection of the common bile duct at the level of confluence and common hepatic duct cutoff (E5–Bismuth type 5 injury) along with transected indwelling biliary stent hanging in the right posterior duct (RPD). At endoscopic retrograde cholangiopancreatography (ERCP), the distal fragment was removed. The RPD stent was cannulated across and retrieved, followed by three plastic stents in the right and left hepatic duct. Prompt referral of a bile duct injury during LC to a specialized center with timely ERCP saved the day and averted the need for surgical intervention.