Assessment of biliary leakage after cholecystectomy
Author(s): Dr. SK Bhatia and Dr. Parmod Kumar
Abstract: Background: Cholecystectomy is one of the most frequently performed procedures in gastrointestinal surgery, and the laparoscopic approach is now the gold standard for symptomatic cholecystolithiasis. The present study was conducted to assess biliary leakage after cholecystectomy.Materials & Methods: 65 patients of biliary leakage after cholecystectomy of both genders were included. Parameters such as clinical presentations following biliary leak, timing of detection of bile leak post operatively, acute or chronic cholecystitis at the time of operation, amount of bile leak, duration of bile leak, postoperative investigation for bile leak, various modalities of management and its outcome, site of bile leak are recorded.Results: Out of 65 patients, males were 38 and females were 27. Open cholecystectomy was performed in 32 and laparoscopic cholecystectomy in 33. Open method had 4 and laparoscopic cholecystectomy had 6 cases of major bile duct injury. The site of injury was GB Bed in 2, cystic duct in 4, CBD in 3 and CHD in 1 case. Management given was conservative with controlled external fistula in 35, suturing of cystic duct in 15, primary suturing in 10 and hepaticojejunostomy in 5 cases. Conclusion: Bile leak from major bile duct injury should be managed promptly and requires skilled surgical intervention.