Management of Bile Duct Injury Reconstruction Using The Ri-Kunaro Technique : A Case Series.

Abstract

Bile duct injury after cholecystectomy represents a potentially dramatic event, associated with significant morbidity and mortality. The rate of bile duct injury ranges between 0.2 and 0.5%. Due to the high numbers of cholecystectomies performed, it is an enormous healthcare problem often leading to long-term physical and psychological morbidity to patients, with mortality described up to 7%. It also is associated with multiple interventions and hospitalizations that generate a significant cost and burden to the patient and healthcare system. The goal of surgical treatment is reconstruction to allow good bile flow to the alimentary tract. In order to achieve this goal, many techniques are used.

We conducted a serial cases study on five months period (May – September 2025) in our center with diagnosed bile duct injury after cholecystectomy (laparoscopic and open surgery). We’ve performed bile duct reconstruction using Ri-Kunaro Technique. 

All patients have been performed exploratory laparotomy + biloma drainage + adhesiolysis + double biliary stent placement + biliary reconstruction. After reconstruction, we also perform sphincterotomy for all patients. Excellent results were obtained in bile duct injury reconstruction using the Ri-Kunaro technique. This technique could be an alternative option for future bile duct injury management.