Timing of definitive surgical repair for iatrogenic biliary injury

Proper timing of repair is one of key factors predicting long term prognosis of iatrogenic biliary injury. Local inflammation is proved related to long-term biliary stricture. This article introduces pathological procedure of biliary injury based on pathophysiological mechanism and animal model research of wound healing, and how to increase intraoperative repair rate based on the clinical evidences. The preoperative active inflammation control and systemic management could create necessary conditions for the the subsequent early repair. At the same time, authors suggest to set individual strategy regarding timing of repair.Delayed repair is recommended for combined vascular injury or severe biliary injury with terrible contamination.