Treatment of Postoperative Bile Leakage in Laparoscopic Cholecystectomy

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  • 腹腔鏡下胆嚢摘出術の術後胆汁瘻に対する治療法

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Abstract

One of the complications after laparoscopic cholecystectomy (LAP-C) is postoperative bile leakage. Of 800 patients undergoing LAP-C at our institution, bile leakage occurred in 12 (1.5%). Whenever postoperative bile leakage was detected, we conducted direct cholangiography and determined whether there was leakage of the contrast medium, the location of the injury, and its severity. Whenever leakage of the contrast medium was detected, if biliary injury was severe, we conducted laparotomy and biliary tract reconstruction. If biliary injury was not severe, we conducted biliary drainage by endoscopic nasobiliary drainage or percutaneous transhepatic biliary drainage and conducted conservative treatment. If leakage of the contract medium was not detected, we conducted only abdominal drainage and observed the clinical course. In this article, we report 7 cases in which leakage of the contrast medium was detected and we conducted biliary drainage and treated the cases conservatively. The average time from the drainage operation until bile leakage stopped was 7.6 days. Since biliary drainage heals bile leakage within a short time and reduces the necessity of operative reintervention in the biliary tract, it is effective in treatment and has the merit of low invasiveness.

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