Medical MCQ-On 7th postoperative day after laparoscopic cholecystectomy, patient developed right upper abdominal pain and 10 cm*8cm collection. Treatment consists of

On 7th postoperative day after laparoscopic cholecystectomy, patient developed right upper abdominal pain and 10 cm*8cm collection. Treatment consists of

Immediate laparotomy

Percutaneous drainage

Laparotomy and surgical exploration of bile duct and T-tube inseion

Roux-en-Y hepaticojejunostomy

Question Category:

Anatomy

Correct Answer:

Percutaneous drainage

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

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