title: Intraperitoneal bile collections after laparoscopic cholecystectomy: causes, clinical presentation, diagnosis, and treatment.
abstract: BACKGROUND
  Bile leakage is more common after laparoscopic cholecystectomy than after open surgery. In our department, the rate of postoperative bile collections after open surgery is 0.2% vs 0.6% after laparoscopic cholecystectomy.
  
  
  METHODS
  We studied 13 cases of intraperitoneal bile collection without common bile duct damage drawn from a total of 5,200 laparoscopic cholecystectomies (0.23%). Clinical presentation, symptoms, method of diagnosis, causes, time of diagnosis, correlation of time of diagnosis with definitive treatment, and postoperative results were analyzed.
  
  
  RESULTS
  The symptoms appeared between the 5th and 8th postoperative days. They were observed in patients with either chronic or acute cholecystitis. The main causes were misapplication of clips at the cystic duct and open Luschka's duct. Ultrasound failed for early recognition of bile collections. The definitive diagnosis was made by repeat ultrasonography, CAT scan, and ERCP.
  
  
  CONCLUSIONS
  The ideal treatment in these cases is a minimally invasive procedure, but since the diagnosis is frequently delayed, open surgery is performed in the majority of patients. However, there were no mortalities in this group of patients.
authors: Department of Surgery, Clinical Hospital, University of Chile, Santiago, Chile.
authors: I
authors: I
authors: Braghetto
authors: J
authors: J
authors: Bastias
authors: A
authors: A
authors: Csendes
authors: A
authors: A
authors: Debandi
mesh_terms: D001646:Bile; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002764:Cholecystitis / Q000150:complications / Q000601:surgery; D004322:Drainage; D006801:Humans; D010529:Peritoneal Cavity; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D015607:Stents; D013997:Time Factors