Bile duct rupture is a complete break or partial defect of the damaged bile duct, or inflammation and fibrosis of the bile leak occurring only by vascular clamp compression or by suturing, and finally causing bile duct stenosis or occlusion. Bile duct rupture is commonly associated with scarring narrowing of the bile duct lumen due to bile duct injury, i.e., benign bile duct stenosis. What are the prevention methods of bile duct rupture? Medical care workers should strictly follow the operation routine to reduce the occurrence of medical source injury;. Develop good living habits to avoid abdominal trauma; actively treat primary diseases such as bile duct stone infection. The consequences of bile duct injury are serious, so it is important to prevent its occurrence. In fact, the majority of bile duct injuries of medical origin can be prevented, the operator should focus on the operation, the operation should be carefully and meticulously, and follow certain routine steps, such as in the implementation of cholecystectomy, first reveal the common bile duct, common hepatic duct and cystic duct, identify the relationship between the three and then use a silk wire to cover the cystic duct, not to cut it off. Then retrograde separation of the gallbladder is done from the bottom of the gallbladder to the point where the cystic duct converges into the common bile duct, and only then is the cystic duct ligated and cut. If the relationship between the above three ducts is not clear when separating the cystic duct, a choledochotomy can be considered and a probe rod can be placed to help determine the position of each bile duct. Intraoperative cholangiography can also be used to help locate the ducts. In addition, the gallbladder should be sheared as close to the wall as possible when separating the gallbladder, and bleeding should be carefully stopped in case of bleeding, avoiding large sutures to stop bleeding, and always be alert to the presence of bile duct malformations. With the accumulation of treatment experience and lessons learned, the concept of “prevention is important” is being advocated by more and more surgeons. In upper abdominal surgery, carelessness is the first cause of biliary injury, and Landibous believes that 2/3 of biliary injuries are caused by experienced surgeons. Anatomic variation is a major cause of intraoperative biliary tract injury. Of course, the inexperience of a significant number of surgeons is another important reason. Currently, trans-laparoscopic cholecystectomy has become the procedure of choice for gallbladder removal. And after the introduction of trans-laparoscopic cholecystectomy, there is an increasing trend of medically induced biliary tract injuries. Indeed, there is a learning process for mastering this procedure, but it should not be at the expense of patient suffering. There has been a lot of literature on how to prevent biliary injury intraoperatively, both nationally and internationally. It is worth mentioning that some modern major hospitals in China are already implementing a system of admission of physicians for surgical qualification. For example, Peking Union Medical College Hospital has clearly defined the qualifications for trans-laparoscopic cholecystectomy, including the level of the surgeon, the number of previous open cholecystectomy cases, the number of previous one-assist trans-laparoscopic cholecystectomy cases, and so on. The fundamental purpose of the physician surgical qualification admission system is to eliminate the occurrence of medically induced injuries at the source, and should be vigorously promoted nationwide. Pre-operative preparation: All patients should be treated surgically, and it is advisable to first actively treat non-operatively (see bile duct stones and cholangitis) for a few patients with poor general condition in order to make good pre-operative preparation. 1, for early fresh bile duct injury, the stenosis section is not long, can be butt-end anastomosis, support drainage for more than 1 year, but the long-term results are mostly unsatisfactory. For those who cannot be anastomosed, various types of biliary-intestinal anastomosis are feasible, but bile duct-jejunum Roux-Y anastomosis is mostly used, if conditions permit. 2.For patients with advanced injury strictures or primary biliary strictures due to biliary inflammation, bile-intestinal anastomosis is also performed to relieve biliary obstruction (see bile duct stones and cholangitis). 3. For stenosis at the hepatic hilum, especially bilateral hepatic duct opening stenosis, the hepatic hilum should be dissected to reveal the hepatic duct 2 cm above the stenosis, or a partial resection of the square lobe of the liver should be performed to reveal it. The stenosis should be dissected across the upper and lower ends of the stenosis, shaped if necessary, and the bile duct lumen enlarged, or even the common bile duct, left or (and) right hepatic duct should be dissected, and lateral-lateral or end-lateral anastomosis with Y-type jejunum should be performed, and the stones in the proximal bile duct should be removed as much as possible to improve the surgical result. 4.For extrahepatic bile duct stricture, free jejunum with vascular tip or gastric piece can be used for repair. 5.For primary bile duct stricture and limited, severe liver lesions, partial hepatectomy is feasible, often for the left outer lobe of the liver. 6.If multiple lesions, accompanied by stones, and serious damage to the liver parenchyma, the above-mentioned combined surgery is required if simple bile-intestinal anastomosis cannot achieve the purpose. In rare cases where definitive repair is not possible, the stenotic segment can be supported and fixed for a long time with a U-shaped tube, or the stenotic bile duct can be dilated with various balloon catheters.