BACKGROUND/ PURPOSE: Leakage of bile is one of the troublesome complications after laparoscopic cholecystectomy. METHODS: The present study reviewed our experience with this complication, in order to analyze its characteristics and proper management. RESULTS: Postoperative bile leaks occurred in 23 of 1365 patients (1.7%) undergoing laparoscopic cholecystectomy from July 1990 to May 2002, with the policy of routine operative cholangiography and routine drainage of the gallbladder bed. These patients could be divided into four types. In type 1 (17 patients), bile leakage stopped spontaneously within 3 days (subclinical group). In type 2 (3 patients), the leak continued for longer than 3 days but was controlled by an endoscopic nasobiliary drainage (ENBD tube; minor-leakage group). In type 3 (2 patients), bile leakage continued for longer than 3 days and required open repair (major-leakage group). In type 4 (1 patient), bile leakage started several days after surgery (delayed-leakage group). CONCLUSIONS: It is thought that better understanding of these four types of bile leakage should help in the proper management of this complication.
BACKGROUND/ PURPOSE: Leakage of bile is one of the troublesome complications after laparoscopic cholecystectomy. METHODS: The present study reviewed our experience with this complication, in order to analyze its characteristics and proper management. RESULTS:Postoperative bile leaks occurred in 23 of 1365 patients (1.7%) undergoing laparoscopic cholecystectomy from July 1990 to May 2002, with the policy of routine operative cholangiography and routine drainage of the gallbladder bed. These patients could be divided into four types. In type 1 (17 patients), bile leakage stopped spontaneously within 3 days (subclinical group). In type 2 (3 patients), the leak continued for longer than 3 days but was controlled by an endoscopic nasobiliary drainage (ENBD tube; minor-leakage group). In type 3 (2 patients), bile leakage continued for longer than 3 days and required open repair (major-leakage group). In type 4 (1 patient), bile leakage started several days after surgery (delayed-leakage group). CONCLUSIONS: It is thought that better understanding of these four types of bile leakage should help in the proper management of this complication.
Authors: Nicola de'Angelis; Fausto Catena; Riccardo Memeo; Federico Coccolini; Aleix Martínez-Pérez; Oreste M Romeo; Belinda De Simone; Salomone Di Saverio; Raffaele Brustia; Rami Rhaiem; Tullio Piardi; Maria Conticchio; Francesco Marchegiani; Nassiba Beghdadi; Fikri M Abu-Zidan; Ruslan Alikhanov; Marc-Antoine Allard; Niccolò Allievi; Giuliana Amaddeo; Luca Ansaloni; Roland Andersson; Enrico Andolfi; Mohammad Azfar; Miklosh Bala; Amine Benkabbou; Offir Ben-Ishay; Giorgio Bianchi; Walter L Biffl; Francesco Brunetti; Maria Clotilde Carra; Daniel Casanova; Valerio Celentano; Marco Ceresoli; Osvaldo Chiara; Stefania Cimbanassi; Roberto Bini; Raul Coimbra; Gian Luigi de'Angelis; Francesco Decembrino; Andrea De Palma; Philip R de Reuver; Carlos Domingo; Christian Cotsoglou; Alessandro Ferrero; Gustavo P Fraga; Federica Gaiani; Federico Gheza; Angela Gurrado; Ewen Harrison; Angel Henriquez; Stefan Hofmeyr; Roberta Iadarola; Jeffry L Kashuk; Reza Kianmanesh; Andrew W Kirkpatrick; Yoram Kluger; Filippo Landi; Serena Langella; Real Lapointe; Bertrand Le Roy; Alain Luciani; Fernando Machado; Umberto Maggi; Ronald V Maier; Alain Chichom Mefire; Kazuhiro Hiramatsu; Carlos Ordoñez; Franca Patrizi; Manuel Planells; Andrew B Peitzman; Juan Pekolj; Fabiano Perdigao; Bruno M Pereira; Patrick Pessaux; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Luca Portigliotti; Raffaele Romito; Boris Sakakushev; Behnam Sanei; Olivier Scatton; Mario Serradilla-Martin; Anne-Sophie Schneck; Mohammed Lamine Sissoko; Iradj Sobhani; Richard P Ten Broek; Mario Testini; Roberto Valinas; Giorgos Veloudis; Giulio Cesare Vitali; Dieter Weber; Luigi Zorcolo; Felice Giuliante; Paschalis Gavriilidis; David Fuks; Daniele Sommacale Journal: World J Emerg Surg Date: 2021-06-10 Impact factor: 5.469