On 5th postoperative day after laparoscopic cholecystectomy, a 50 year old lady presented with right upper quadrant pain with fever and 12 cm subhepatic collection on CT and ERCP shows cystic duct leak. The best management is
Correct Answer: Percutaneous drainage of fluid
Description: Goals of therapy in Iatrogenic bile duct injury Control of infection limiting inflammation Parenteral antibiotics Percutaneous drainage of peripoal fluid collection Clear and thorough delineation of entire biliary anatomy MRCP/PTC ERCP (especially if cystic duct stump leak suspected) Re-establishment of biliary enteric continuity Tension free, mucosa - to-mucosa anastomosis Longterm transanastomotic stents if involving bifurcation of higher Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno :1503
Category:
Anatomy
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