Approach to a Patient with Post Laparoscopic Cholecystectomy Bile Leak
Received Date: Dec 19, 2017 / Accepted Date: Dec 24, 2017 / Published Date: Dec 31, 2017
With the widespread practice of laparoscopic cholecystectomy and the advancements in imaging and endoscopic therapy the management of bile leaks following cholecystectomy has evolved over the years. Majority of the bile leaks are detected post-operatively. A high index of suspicion should exist for a possible bile leak if a patient presents with abdominal pain, fever, and tenderness within a week following a complicated or converted laparoscopic cholecystectomy, or it may present as an overt external biliary fistula. Leaks which are detected intra-operatively and managed appropriately carry the best prognosis. Interventional radiologists along with expert endoscopists can successfully manage many of the minor bile leaks. Major bile duct injuries should be properly characterized by appropriate imaging studies. One should avoid undue haste while opting for surgical interventions which are invariably required for such major injuries. Such repairs should be undertaken by expert hepatobiliary surgeons as the first repair has the greatest chance of success and failed repairs raises the level of injury making subsequent repairs more difficult.
Keywords: Laparoscopic cholecystectomy; Bile duct injury; External biliary fistula; Bilioma; Biliary ascites; Biliary reconstruction
Citation: Bhattacharjee PK. Approach to a Patient with Post Laparoscopic Cholecystectomy Bile Leak. Journal of Surgery [Jurnalul de chirurgie]. 2017; 13(4): 109- 113. Doi: 10.7438/1584-9341-13-4-1
Copyright: © 2018 Bhattacharjee PK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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