A Study on Biliary Leakage after Cholecystectomy
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 5
Abstract
Introduction: Biliary leakage is the most serious and dreaded complication after cholecystectomy. The early and accurate diagnosis of bile duct injury is very important for surgeons, because unrecognized bile duct injury leads to serious complications such as biliary peritonitis, hepatic failure and death and also plays a vital role in management of biliary leak after cholecystectomy. Study aimed to evaluate the various modalities of treatment and their outcome in biliary leakage following cholecystectomy. Material and methods: Prospective study. The data were obtained from the patients getting admitted with biliary leakage after cholecystectomy or developed biliary leakage after cholecystectomy at the Department of General surgery, Assam Medical College from July 2014 to June 2015 who were properly examined, investigated, treated and followed up for one month. Results: A total of 1190 Cholecystectomies were carried out in this study period in my institution, out of which 785 were open cholecystectomies and rest 405 were laparoscopic cholecystectomies. In this study, 20 bile leak cases were registered, out of which 6 were diagnosed as major bile duct injury and another 4 cases of bile leak were diagnosed as originated either from GB bed, duct of luschka or minor bile duct injury. In the rest 10 cases, bile leak was presumed to be either from GB bed, duct of luschka or minor bile duct injury as they resolve spontaneously after conservative management. In this study the incidence of major bile duct injury after cholecystectomy is 0.50 whereas the overall incidence of bile leak after cholecystectomy is 1.68. Conclusion: Biliary leakage after cholecystectomy caused by major bile duct injury is infrequent though not usual. In majority of cases bile leak occurs either from unsuspected accessory bile duct, duct of Luschka, GB bed or from minor bile duct injury, which needs only conservative management and careful observation. Only bile leak from major bile duct injury should be managed promptly and requires skilled surgical intervention.
Authors and Affiliations
Abhinandan Goswami, Mituban Gogoi, Mustafa Abdur Rahman
Keywords
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