Leak after Laparoscopic Cholecystectomy; Incidence and Management

Abstract

Background: laparoscopic cholecystectomy is currently the procedure of choice for symptomatic gallstones. It has evolved from an innovative, but time-consuming, novelty to a routine day-case procedure over the last 20 years. Purpose: to estimate the incidence and management options of post laparoscopic cholecystectomy biliary leaks. Also, it is a trial to advocate a minimally invasive structured management protocol to treat patients with bile leak. Patients and Methods: this study was a case series of 100 patients who underwent laparoscopic cholecsystectomy. We didn’t include patients who had: Biliary leak post Laparoscopic converted to open cholecystectomy. Biliary leak due to other procedures. Biliary leaks managed by open surgery. Biliary injuries discovered and definitively managed intra-operatively. The included patients presented to the General Surgery Department at Manshyt El Bakry General Hospital. Patients’ age ranged from 12 to 65 years and patients’ sex was distributed as 78 females and 22 males. Results: in our cases there were two out of the 100 patients suffered from biliary leak ,one of the two cases that were presented with biliary leak after surgery was due to direct injury to accessory duct of Luschka and the other one was due to a slipped clips. Conclusion: cholecystectomy is the most frequently performed abdominal operation in the United States, with currently over 700,000 cases occurring per year. Bile leak as a result of cholecystectomy is uncommon. The frequency in large series is less than 2% and in our study it was exactly 2%. And the treatment of that leak varies from conservative treatment to ERCP and stent insertion like we did.