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Management of bile leakage after laparoscopic cholecystectomy based on etiological classification

, : Management of bile leakage after laparoscopic cholecystectomy based on etiological classification. Surgery Today 34(4): 326-330

To analyze and classify bile leakage after laparoscopic cholecystectomy (LC) according to its etiology. This classification will help to determine the most appropriate management strategy, whereby unnecessary intervention can be avoided. We examined the medical records of 16 patients in whom bile leakage occurred as a complication of LC. Bile leakage was classified according to its cause into the following groups: insecure closure of the cystic duct stump (n = 3); retention of a common bile duct (CBD) stone (n = 1); CBD injury (n = 10); unsuspected accessory bile ducts (n = 1); and unknown origin (n = 1). The management strategies included observation (n = 3), laparoscopic intervention with drainage (n = 4), laparotomy with drainage (n = 3), and laparotomy with Roux-en-Y choledochojejunostomy for CBD transection (n = 6). All 16 patients recovered uneventfully with similar hospitalization. Bile leakage is not always caused by bile duct injury, and it would be inappropriate to attribute leakage to bile duct injury if there is a retained CBD stone, an unsuspected accessory duct, or an unsecured cystic duct stump. Thus, the management of each condition should vary accordingly. Reviewing a videotape of the surgery and early cholangiogram can help to establish the etiological diagnosis and select the most appropriate course of action.


PMID: 15052447

DOI: 10.1007/s00595-003-2712-2

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Huxham, M.; Gilpin, L.; Mocogni, M.; Harper, S., 2006: Microalgae, macrofauna and sediment stability: an experimental test of a reciprocal relationship. A manipulative field experiment was conducted at Blackness in the Firth of Forth, Scotland, to study the effects of differences in microphytobenthos abundance on sediment stability and macrofauna. Opaque and transparent Perspex was used to constru...

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Nissan, E., 1961: Neurilemmoma of the orbit. Case report. Israel Medical Journal 20: 323-327

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Zherebtsov, P.I.; Vrakin, V.F., 1963: Excretion of radioactive phosphorus and calcium in bile and pancreatic juke of sheep.. I/m injected Ca-45 (as chloride) or P-32 (as sodium phosphate) was present in bile and pancreatic juice after 5 min., reaching maximal concentrations after 9-10 hours in pancreatic juice and 3-4 hours in bile.