Definition and outcomes of postoperative biliary fistula after bile duct injury repair surgery

Abstract

Background: Bile duct injury remains constant since the introduction of laparoscopic cholecystectomy. In many instances, the placement of a stent is the treatment of choice. Otherwise, a bilioenteric anastomosis is required. Postoperative biliary fistula is a recognized complication of the procedure. The evolution of the leak is variable, it is quite common in the very early postoperative period, and in most cases no more procedures will be necessary. In some instances, on the contrary the leak persists, often requiring the placement of intrahepatic drains to control the fistula. Perpetuation of the leak is an adverse situation for the final result of the anastomosis, and until now there is no definition that adequately refers the volume of output or number of days needed to become a clinically relevant fistula. The aim of this study is to analyze the frequency, management, and outcome in patients with postoperative biliary fistula according to our definition in a high-volume bile duct repair center.