Post Cholecystectomy Essay

Aim : The aim of this study is to know the out come of post cholecystectomy biliary leaks and its management methods.

Meterials&Methods: 10 cases of biliary leaks were studied from 100 open cholecystectomies and 100 laparoscopic cholecystectomies from 2013 January to 2014 January

Preoperative workup with ultrasound abdomen .LFT and other biochemical investigations .diagnosis established .the out come of surgery and its most common postoperative complication-biliary leak was studied with following parameters:

postoperative diagnosis surgery - lap or open incision method of approach – fundus or classical method

CBD exploration intra operative findings drains used post operative symptoms amount of collections removal of drains

USG – Sub hepatic collections

ERCP.

Management

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The surgery is associated with many avoidable complications and hence requires a serious and cautious approach .The frequency of bile duct injury remains fairly constant .The seriousness of this complication relates in part of problems of biliary fistula and uncontrolled sepsis and in part to the technical difficulties of successful repair of bile duct injuries.

Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallstones unless there are contraindications to the laparoscopic approach. Sometimes a laparoscopic cholecystectomy may be converted to an open cholecystectomy for technical reasons or safety.

Complications associated with cholecystectomy are bile duct injuries, bile leak from accessory bile ducts or due to clip displacement from the cystic duct, retained stones in the common bile duct, perforation of gallbladder, bleeding from liver, cystic or hepatic artery, subphrenic abscess and peritonitis. Bile duct injuries are important because they are preventable, but once they occur, they may be associated with considerable morbidity and