Management of Post Laparoscopic Cholecystectomy (Bile leakage)

Abdelwahab, Mostafa Baiuomy; Salama, Refaat Salama; Aboelgoud, Mazen Abdelazem; Hekil, Karem M.

doi:10.21608/bmfj.2024.314072.2172

Management of Post Laparoscopic Cholecystectomy (Bile leakage)

Articles in Press

Document Type : Original Article

Authors

¹ Professor of General Surgery, Faculty of Medicine, Benha University

² Assistant Professor of General and Oncology Surgery, Faculty of Medicine, Benha University

³ (M.B.B.Ch, Faculty of Medicine, Benha University)

⁴ Departments of General Surgery, Benha University, Benha, Egypt.

10.21608/bmfj.2024.314072.2172

Abstract

Background: Laparoscopic cholecystectomy is a minimally invasive procedure and an accepted technique for the treatment of gallbladder disease. Complications of bile duct injury vary in their potential morbidity. A biliary leak can cause biloma, abscess, wound infection, intraabdominal infection, and sepsis. This study aimed to assess different types of bile duct injuries after laparoscopic cholecystectomy and the outcome of different interventional procedures. Methods: This retrospective study was carried on 30 subjects with bile leak after laparoscopic cholecystectomy. All studied cases were subjected to laboratory investigations [CBC, liver evaluation, INR, bilirubin total and direct and Alkaline phosphatase and S GGT.], pelvic abdominal U S, computerized tomography, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), intra operative cholangiogram, Hida scan, PTC and PTD. Results: According to the comparison between early and late intervention subjects regarding long term complications, stricture was reported in 15% of the Early group and 20% of the Late group. Recurrent cholangitis was observed in 10% of both groups. Re-intervention or dilation was required in 15% of the Early group and 20% of the Late group. The table also notes that 60% of the Early group and 50% of the Late group did not experience any long term complications. Conclusion: The importance of early diagnosis and tailored therapeutic interventions in managing bile leakage following laparoscopic cholecystectomy. The timing of diagnosis significantly influences the choice of intervention, with earlier detection enabling less invasive procedures.

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