2019 Volume 33 Issue 5 Pages 824-831
Of 1,222 patients who underwent laparoscopic cholecystectomy (LC), 13 patients with postoperative bile leakage were included in this study. Leakage occurred in 5 (0.4%) LC and 8 (11.1%) patients with conversion to laparotomy. Leakage was observed <24 hours and ≥24 hours after surgery in 10 and 3 patients, respectively. The site of bile leakage was detected; with LC completion, the cystic duct stump (n=1); with conversion to laparotomy, the stump of the gallbladder neck (n=5) and the fistula of PTGBD (n=1). The site was not detected in 6 patients. Treatment included a drain placed during surgery (DS) (n=7), exchange of DS (n=1), endoscopic nasobiliary drainage (ENBD) +right subphrenic drainage (n=1), DS+right subphrenic drainage (n=1), DS+liver bed drainage (n=1), and ENBD (n=2). The mean time for bile leakage resolution was 10.6 days. Bile leakage commonly occurred in subtotal cholecystectomy patients who underwent conversion to laparotomy due to difficulty in managing the gallbladder neck.
