ABSTRACT

To discuss the importance of minimally invasive treatment options in the management of bile leaks after laparoscopic cholecystectomy and to present our approach in the management.

Management of 25 patients with symptomatic bile leak after laparoscopic cholecystectomy was retrospectively evaluated. Percutaneous collection drainage, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and percutaneous biliary drainage were performed regarding the presenting symptoms of the patients for the management.

Mean age of the patients (15 women, 10 men) was 55. Either ultrasonography or computed tomography guided percutaneous drainage was performed in 13 patients. By only percutaneous drainage 9 of the patients were completely recovered. In 4 of them ERCP was performed because of high drainage volume. In 9 of the patients with jaundice and high bilirubin levels ERCP was performed as the first option. And 3 patients were reoperated because of acute abdomen signs. ERCP, MRCP and PTC revealed type A in 7, type E2 in three, type E3 in three and type E4 in one of the patients according to Strasberg classification.

Presenting symptoms of the patients with symptomatic bile leaks are helpful in the determination of the treatment option.

Keywords: Bile leak, laparoscopic cholecystectomy, percutaneous collection drainage, endoscopic retrograde cholangiopancreatography, percutaneous biliary drainage