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2011, Number 3

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Rev Med Inst Mex Seguro Soc 2011; 49 (3)

Conservative treatment of the bile leak after laparoscopic cholecystectomy

Pacahuala-del Carmen MA, Enríquez-Adalid MR

Language: Spanish
References: 26
Page: 301-306
PDF size: 40.73 Kb.


ABSTRACT

Objective: to report the outcome of conservative treatment in patients with bile lake (BL) after of laparoscopic cholecystectomy, using basic diagnosis methods and clinic monitoring.
Methods: six hundred and fifty eight patients underwent laparoscopic cholecystectomy. They were evaluated according to their medical history, hepatic function panel, amylase, gallbladder and bile ducts ultrasonographic pattern. In cases of suspected choledocholithiasis a selective intraoperative cholangiography was performed. For patients whit BL a controlled monitoring system was established, checking vital signs, abdominal symptoms; BL was quantificated until it’s remission. These patients were under surveillance for a year.
Results: thirteen patients (1.9 %) out of 658 presented BL. Two males and 11 females, with an average age of 43. The initial BL average was 71.1 mL in 24 hours and the average number of days with the conservative treatment was 7.3. All patients had a favorable clinical evolution except for one who presented BL for a period of 18 days coincident with a subhepatic abscess that was drained.
Conclusion: BL after laparoscopic cholecystectomy can be treated in a safe and effective way, monitoring with clinical elements and basic laboratory and imaging resources.


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