Nuclear medicine case of the day. Bile leak after laparoscopic cholecystectomy.

1992 ◽  
Vol 158 (6) ◽  
pp. 1385-1386 ◽  
Author(s):  
S K Lawrence ◽  
D Delbeke
Keyword(s):  
Nuclear Medicine ◽  
Laparoscopic Cholecystectomy ◽  
Bile Leak

scholarly journals Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Amanda M. Marsh ◽  
Ayman Almousa ◽  
Thomas Genuit ◽  
David Forcione ◽  
Karin Blumofe
Keyword(s):  
Gastric Bypass ◽  
Laparoscopic Cholecystectomy ◽  
Gastric Bypass Surgery ◽  
Duodenal Bulb ◽  
Bile Leak ◽  
Signs And Symptoms ◽  
Remnant Stomach ◽  
Perforated Ulcer ◽  
Contrast Extravasation ◽  
Biliopancreatic Limb

Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the biliopancreatic limb. We present a patient with signs and symptoms of acute cholecystitis. Laparoscopic cholecystectomy was complicated by postoperative bile leak. EDGE procedure was performed to access the remnant stomach and endoscopic evaluation revealed a perforated ulcer in the posterior duodenal bulb. Although unusual, in patients with bariatric surgery and upper abdominal pain, differential diagnosis including perforated ulcer of the biliopancreatic limb must be considered and early surgical exploration is essential.

scholarly journals Retroperitoneal bile leak after laparoscopic cholecystectomy

2018 ◽  
pp. bcr-2017-222750
Author(s):  
Dee Zhen LIM ◽  
Enoch Wong ◽  
Sayed Hassen ◽  
Yahya AL-Habbal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Leak

CASE REPORT: Radiological and endoscopic management of bile leak following laparoscopic cholecystectomy

1997 ◽  
Vol 12 (1) ◽  
pp. 34-38 ◽  
Author(s):  
BASSAM M SAMMAK ◽  
BUSHRA A YOUSEF ◽  
MOHAMED H GALI ◽  
MOHAMED A AL KARAWI ◽  
ABDULRAHMAN E MOHAMED
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Bile Leak ◽  
Endoscopic Management

Endoscopic management of post laparoscopic cholecystectomy bile leak in a child

2000 ◽  
Vol 51 (4) ◽  
pp. 506-507 ◽  
Author(s):  
Hari Prasad ◽  
Ujjal Poddar ◽  
Babu R. Thapa ◽  
Deepak K. Bhasin ◽  
Katragadda L.N. Rao ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Leak ◽  
Endoscopic Management

scholarly journals ASSESSMENT OF FEASIBILITY AND COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY IN CIRRHOTIC PATIENTS

2017 ◽  
Vol 10 (7) ◽  
pp. 272
Author(s):  
Nitin Goyal ◽  
Anshuman Pandey ◽  
Shakeel Masood ◽  
Smita Chauhan ◽  
Alankar Gupta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Average Length ◽  
Bile Leak ◽  
Length Of Hospital Stay ◽  
Preoperative Optimization ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Cirrhotic Patients ◽  
Difficult Cholecystectomy ◽  
Open Port ◽  
Additional Port

Abstract :Introduction: From the era of absolute contraindication to the phase of preferred treatment, the technique of laparoscopic cholecystectomy advances with time. Here, we report our experience of laparoscopic cholecystectomy in 20 patients of liver cirrhosis. In our institute, laparoscopic cholecystectomy is the preferred choice for cholelithiasis in cirrhotic patient.Methods: In last 2 years, 180 laparoscopic cholecystectomies were performed and 20 patients were cirrhotic. Their data analyzed retrospectively in terms of preoperative optimization, operative technique and results.Results: Laparoscopic cholecystectomy was completed successfully in 19 patients and one was converted to open. Mean operative time was 54 minutes. No additional port was required in all cases. Calot’s first dissection was performed in 18 patients and fundus first technique was used in 2 patients due to unclear anatomy. Liver bed bleeding was present in 16 patients, which was controlled effectively. Subhepatic drain was placed in 12 patients. There was no mortality. Morbidity  in two patients was worsening of ascites in one; and incisional hernia in other patient which was converted to open. Port site complications were not noted in any patient and there was no evidence of intraabdominal bleeding or bile leak postoperatively. Blood and component transfusion was required in 2 patients. Average length of hospital stay was 4.8 days.Conclusion: Though laparoscopic cholecystectomy may be difficult in cirrhotic patients but it is feasible and relatively safe. It offers many advantages in cirrhotic patients and associated with low morbidity when compared with open surgery.Keywords: cirrhosis, laparoscopic cholecystectomy, difficult cholecystectomy

scholarly journals Early Laparoscopic Cholecystectomy with Continuous Pressurized Irrigation and Dissection in Acute Cholecystitis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
I. Ozsan ◽  
O. Yoldas ◽  
T. Karabuga ◽  
U. M. Yıldırım ◽  
H. Y. Cetin ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Admission ◽  
Acute Cholecystitis ◽  
Symptom Onset ◽  
Open Surgery ◽  
Bile Leak ◽  
Conversion To Open Surgery ◽  
Conversion Rates ◽  
Pressurized Irrigation ◽  
Dissection Technique

Background. The aim of this study was to evaluate the preliminary results of a new dissection technique in acute cholecystitis.Material and Method. One hundred and forty-nine consecutive patients with acute cholecystitis were operated on with continuous pressurized irrigation and dissection technique. The diagnosis of acute cholecystitis was based on clinical, laboratory, and radiological evidences. Age, gender, time from symptom onset to hospital admission, operative risk according to the American Society of Anesthesiologists (ASA) score, white blood cell count, C-reactive protein test levels, positive findings of radiologic evaluation of the patients, operation time, perioperative complications, mortality, and conversion to open surgery were prospectively recorded.Results. Of the 149 patients, 87 (58,4%) were female and 62 (41,6%) were male. The mean age was46.3±6.7years. The median time from symptom onset to hospital admission 3.2 days (range, 1–6). There were no major complications such as bile leak, common bile duct injury or bleeding. Subhepatic liquid collection occurred in 3 of the patients which was managed by percutaneous drainage. Conversion to open surgery was required in four (2,69%) patients. There was no mortality in the study group.Conclusion. Laparoscopic cholecystectomy with continuous pressurized irrigation and dissection technique in acute cholecystitis seems to be an effective and reliable procedure with low complication and conversion rates.

scholarly journals An Algorithm for the Management of Bile Leak Following Laparoscopic Cholecystectomy

2007 ◽  
Vol 89 (1) ◽  
pp. 51-56 ◽  
Author(s):  
F Ahmad ◽  
RN Saunders ◽  
GM Lloyd ◽  
DM Lloyd ◽  
GSM Robertson
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Bile Leak ◽  
Median Hospital Stay ◽  
Management Protocol ◽  
The Impact ◽  
Median Hospital ◽  
Bile Leaks

INTRODUCTION The management of bile leaks following laparoscopic cholecystectomy has evolved with increased experience of ERCP and laparoscopy. The purpose of this study was to determine the impact of a minimally invasive management protocol. PATIENTS AND METHODS Twenty-four patients with a bile leak following laparoscopic cholecystectomy were recorded consecutively between 1993 and 2003. Between 1993–1998, 10 patients were managed on a case-by-case basis. Between 1998–2003, 14 patients were managed according to a minimally invasive protocol utilising ERC/biliary stenting and re-laparoscopy if indicated. RESULTS Bile leaks presented as bile in a drain left in situ post laparoscopic cholecystectomy (8/10 versus 10/14) or biliary peritonitis (2/10 versus 4/14). Prior to 1998, neither ERC nor laparoscopy were utilised routinely. During this period, 4/10 patients recovered with conservative management and 6/10 (60%) underwent laparotomy. There was one postoperative death and median hospital stay post laparoscopic cholecystectomy was 10 days (range, 5–30 days). In the protocol era, ERC ± stenting was performed in 11/14 (P = 0.01 versus pre-protocol) with the main indication being a persistent bile leak. Re-laparoscopy was necessary in 5/14 (P = 0.05 versus preprotocol). No laparotomies were performed (P < 0.01 versus pre-protocol) and there were no postoperative deaths. Median hospital stay was 11 days (range, 5–55 days). CONCLUSIONS The introduction of a minimally invasive protocol utilising ERC and re-laparoscopy offers an effective modern algorithm for the management of bile leaks after laparoscopic cholecystectomy.

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