Post-cholecystectomy bile leak is not always synonymous with acute bile duct injury: Need for reclassification

摘要

cqvip:Bile leak after laparoscopic cholecystectomy remains a significant cause of postoperative morbidity.Cystic duct stump is the most common site(~70%)of bile leak after cholecystectomy[1].Incidence of bile leak from the cystic duct stump is 0.5%−3%which is higher(4%−7%)in cases with complicated gallstone disease(e.g.acute cholecystitis)[2].Bile leak in postoperative period after cholecystectomy,manifesting as bile in intraoperatively placed drain or as an intrabdominal collection,localized or generalized,is considered a complication secondary to bile duct injury(BDI)that was sustained during the procedure.Irrespective to the site of leak,such bile leak is classified as an iatrogenic BDI,and is subsequently categorised depending on the site of leak if that is localized on subsequent investigations.