Abstract
We describe a case of delayed bile leakage after laparoscopic cholecystectomy. A 48-year-old woman suffering from cholelithiasis was admitted to our hospital. We performed laparoscopic cholecystectomy with careful manipulation due to the low junction of the cystic duct. The patient was discharged uneventfully. She was readmitted because of abdominal pain after the operation. She did not recover with conservative therapy. Abdominal computed tomography (CT) showed fluid collection around the dorsal area of the cystic duct as delayed bile leakage. Emergent endoscopic retrograde cholangiopancreatography (ERCP) was performed and showed bile leakage from the cystic duct. We performed endoscopic nasobiliary drainage (ENBD), and ENBD radiography showed bile leakage from the posterior branch of the bile duct. After recovery of the leakage, the ENBD tube was removed. The patient still had abdominal pain after ENBD tube removal, so we conducted ENBD again. We exchanged the ENBD tube for an endoscopic retrograde biliary drainage tube one week later, and she was able to leave the hospital.
