DIAGNOSTIC AND THERAPEUTIC INTERVENTIONS IN POST-LAPAROSCOPIC CHOLECYSTECTOMY BILIARY COMPLICATIONS

Radiological imaging and therapeutic interventions were performed in e ight patients with biliary complications following laparoscopic cholec ystectomy. The diagnostic approach and the outcome of the therapeutic procedures were evaluated. Complications observed were bile leakage fr om the cystic duct stump (n = 2); erroneous identification of the cyst ic duct leading to common hepatic duct transection (n = 1) and hepatic duct ligation (n = 2); liver abscess (n = 1); and retained common duc t stones (n = 2). Diagnostic ultrasonography is capable of detecting t he presence of abnormal fluid collection and the diameter of the commo n duct with or without the presence of a stone, although bile leaks an d retained common duct stones can only be demonstrated by either endos copic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. Once a bile leak had been confirmed, therapeutic end oscopic biliary stenting was successfully applied in one patient while the other received percutaneous transhepatic biliary drainage. Defini tive diagnosis of retained common duct stone was established by endosc opic retrograde cholangiopancreatography, and immediate endoscopic sph incterotomy with stone extraction was performed. Follow-up radiologica l imaging was done to determine the effectiveness of the therapeutic p rocedures applied in each patient. All our patients improved clinicall y, and further surgical intervention was not needed.