In the 1990s, laparoscopic cholecystectomy (LC) supplanted open cholecystectomy in the treatment of gallbladder disease. But the use of LC has led to a rise in bile duct injuries (BDI). Despite the frequency of BDI, there are few reports on longitudinal, multidisciplinary care. Methods: From 1990-2003, a database of patients (pts) with a BDI during LC was maintained. Charts were retrospectively analyzed for surgical/interventional radiologic (IR) care and complications. Results: Over 13 yrs, 200 pts were treated. There were 150 women (75%) with a mean age of 45.5 yrs. 12 BDI were sustained at our hospital. 9 were immediately repaired and 3 were diagnosed by percutaneous transhepatic cholangiography (PTC) and repaired within 7-96 d. 188 pts were referred 29.1±62.5 wks after BDI (median 3) with bile leak/biloma (42.6%), jaundice (29.3%), or cholangitis (20.2%). Before repair, 3 deaths occurred due to sepsis. Initial IR work-up included 362 visits by 188 pts. Ultimately, 130 pts (69.1%) had 180 bile stents inserted (range 1-4) and 22 pts (11.5%) had 36 biloma drains placed (range 1-10). Prior to definitive repair, 82 pts (44.3%) underwent elective or emergent cholangiography (c-gram)/stent changes during 352 IR visits (4.3/pt). Common indications were cholangitis (30.8%) and minor stent problems (51.4%). 22 pts had intact biliary-enteric continuity and underwent successful balloon dilatation. Overall, 175 pts had repairs including 172 hepaticojejunostomies (98%). There were 3 post-op deaths. Post-op c-gram revealed anastomotic leak in 4.5% and liver dome-stent exit site extravasation in 10.3% of pts. 8.4% of these were treated by new stent placement or drainage. After discharge, in+out-pts underwent 1022 IR visits for 1374 stent changes or 12 abscess drainages. Of the visits, 54.6% were elective while the rest were for stent problems (55.7%), cholangitis (24.8%), jaundice (2.6%), or abscess (2.4%). There was no difference in post-op readmission rates or in the rates of cholangitis, abscess/biloma, jaundice, bile leak, or wound infection based on the number of stents inserted at repair. Conclusion: Our series represents the largest single institution report of the surgical-IR management of BDI after LC. Treatment of these pts is labor intensive for surgeons and radiologists in the pre-/post-operative settings. Coordinated multidisciplinary care, including biliary stenting, appears to assure optimal results without impacting the rates of common complications.