A Case of Delayed Bile Leakage after Laparoscopic Cholecystectomy

DOI
  • Ishii Kaname
    Department of Surgery Public Central Hospital of Matto Ishikawa
  • Kanamoto Ayako
    Department of Surgery Public Central Hospital of Matto Ishikawa
  • Yagi Masao
    Department of Surgery Public Central Hospital of Matto Ishikawa
  • Asai Jyun
    Department of Gastroenterological Medicine Public Central Hospital of Matto Ishikawa

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Other Title
  • 腹腔鏡下胆囊摘出術後に遅発性に胆汁瘻を発症した1例

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Description

We encountered a case of delayed bile leakage after laparoscopic cholecystectomy. A 39-year-old man was hospitalized due to gall bladder stones. We performed laparoscopic cholecystectomy and the patient was discharged after an uneventful postoperative course. On the 8th postoperative day, however, he presented with abdominal pain. Abdominal CT showed fluid collection around the dorsal area of the cystic duct, and bile leakage was suspected. On the 9th postoperative day, the fluid collection spread to the surface of the liver. Emergency endoscopic retrograde cholangiopancreatography (ERCP) was performed, which showed bile leakage from the cystic duct. We diagnosed delayed bile leakage developing after laparoscopic cholecystectomy, and endoscopic nasobiliary drainage (ENBD) was performed. After 11 days, ENBD contrast radiography confirmed the absence of further leakage, and the ENBD tube was removed. We considered that bile leakage was caused by ultrasonically activated device and ENBD the useful therapy for bile leakage after laparoscopic cholecystectomy. Careful manipulation of devices is crucial during cholecystectomy.

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