Harsukh Educational Charitable Society International Journal of Community Health and Medical Research
Volume 4 Issue 2 April-June 2018
|Evaluation of the Treatment Outcomes in cases with Bile Leakage following Cholecystectomy|
|Ram Shringar Dubey, OP Pandey|
Background: The most desirable treatment of choice of treatment of bile leakage following cholecystectomy is Endoscopic retrograde cholangiopancreatography (ERCP) with placement of a biliary stent or drain. Aim of the study:To study the treatment outcomes in cases with bile leakage following cholecystectomy.Materials and methods:The study was conducted in the department of general surgery of the medical institute. We included 45 patients admitting to the Department of General Surgery with biliary leakage after cholecystectomy or developed biliary leakage after cholecystectomy from January 2017 to June 2017. Patients between the ages of 14 years to 60 years were included in the study.We collected data such as clinical presentations following biliary leak, timing of detection of bile leak post operatively (< 24 hour or > 24 hour), acute or chronic cholecystitis at the time of operation, amount of bile leak, duration of bile leak, postoperative investigation (MRCP, CT abdomen, USG) for bile leak, various modalities of management and its outcome, site of bile leak. Results:In the present study a total of 45 cases were included in the study. The age of the patients ranged between 14 to 60 years with mean age at 42.21 years. No. of male patients was 29 and no. of female patients was 16. No. of cases which underwent open cholecystectomy was 29 and no. of cases which underwent laparoscopic cholecystectomy was 16. The major bile duct injury was seen in 7 patients who underwent open cholecystectomy and 6 patients who underwent laparoscopic cholecystectomy. We observed that conservative treatment with controlled external fistula was performed on 35 patients. Operative treatment was performed on 10 patients. Conclusion: The injury to bile duct during cholecystectomy procedure can be very deliberating to the patients and proper steps should be taken for early diagnosis and treatment to avoid such deliberating condition. In our study, conservative treatment was significantly efficacious. Keywords: Bile leakage, laparoscopic cholecystectomy, open cholecystectomy.
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