Biliary leak after laparoscopic cholecystectomy; incidence and management

Abstract

Background: Biliary leak represent an unusual complication of laparoscopic cholecystectomy (LC). The origin of the biliary leak is multifactorial, which may arise from GB bed, cystic, or injuries of a major bile duct. Even with standardization and growing experience, LC still duct, involves the threat of damage of the biliary tree. Patients and Methods: This retrospective study was achieved at the department of general surgery, Al-Azher University, Assiut between October 2015to September 2020. The current study was a case series of 1000 cases who underwent LC. Twenty cases complaining of biliary leakage post-LC had been reported consecutively. The age of Patients was (14-65) years and sex was dispensed as 780 females and 220 males. Results: In the current study there were 20 cases out of the 1000 patients that underwent LC complained from biliary leakage, 14 patients of the twenty patients were presented with bile leakage post LC which were attributed to gallbladder Bed, Duct of Luschka, and minor accessory duct, two case due to insecure or slipped ligature of the cystic duct, and a slipped clip and 2cases due to injury to CHD and other two cases due to direct injury to CBD. The definitive treatment of biliary leakage was done. All cases were treated therefore with the use of endoscopy in 4 cases (plus percutaneous techniques in 3 patients) and surgical intervention in 1 patient and one patient died. Conclusion: The endoscopic management proved very effective in cases with simple biliary leakage than patients with complex bile leaks.