Abstract:Iatrogenic bile duct injury (IBDI) is a common type of bile duct injury, most frequently occurring during cholecystectomy. With the widespread use of laparoscopic cholecystectomy, its incidence is significantly higher than that of open surgery, and the number of complex cases combined with vascular injury (VI) has been increasing, posing greater challenges for diagnosis and treatment. In severe cases, it may result in hepatic ischemia and atrophy. Hepaticojejunostomy is the standard reconstructive procedure after bile duct injury, whereas hepatectomy may be required when VI is involved. We report the case of a 53-year-old woman who was admitted with bile leakage following cholecystectomy. After two multidisciplinary team (MDT) discussions, preoperative evaluation revealed injury to the right hepatic artery and a portal vein branch, accompanied by atrophy of the right anterior lobe. Based on intraoperative findings, the patient underwent right hepatectomy combined with Roux-en-Y hepaticojejunostomy of the left hepatic duct. Postoperative recovery was uneventful, and the patient remained symptom-free during a 6-month follow-up. By reviewing the diagnosis and management of this case in conjunction with relevant literature, we summarize the clinical features, treatment strategies, and the value of MDT management in complex IBDI, aiming to provide reference for clinical practice.