IT IS DIFFICULT or impossible to determine the incidence of injuries of the hepatic or common bile ducts which occur in the course of operations on the biliary system. Kehr1 in 1913 reported injury to the common and hepatic ducts fifteen times in one thousand cholecystectomies, or an incidence of 1.5 per cent. Jacobson2 reviewed the literature up to 1914 and found only 34 cases. Since then, other injuries of this type have been described (Eliot3 and Eisendrath4), but the reviews do not give an accurate idea of the frequency of injury of the common duct since most cases are not reported.
Injuries to the common duct may occur as a result of inflammation of the duct or trauma to the duct. Cole and his associates5 reported that 76 per cent of a series of strictures were the result of operative injury, Cattell6 80