title: Features and management of bile leaks after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Leakage of bile is one of the troublesome complications after laparoscopic cholecystectomy.
  
  
  METHODS
  The present study reviewed our experience with this complication, in order to analyze its characteristics and proper management.
  
  
  RESULTS
  Postoperative bile leaks occurred in 23 of 1365 patients (1.7%) undergoing laparoscopic cholecystectomy from July 1990 to May 2002, with the policy of routine operative cholangiography and routine drainage of the gallbladder bed. These patients could be divided into four types. In type 1 (17 patients), bile leakage stopped spontaneously within 3 days (subclinical group). In type 2 (3 patients), the leak continued for longer than 3 days but was controlled by an endoscopic nasobiliary drainage (ENBD tube; minor-leakage group). In type 3 (2 patients), bile leakage continued for longer than 3 days and required open repair (major-leakage group). In type 4 (1 patient), bile leakage started several days after surgery (delayed-leakage group).
  
  
  CONCLUSIONS
  It is thought that better understanding of these four types of bile leakage should help in the proper management of this complication.
authors.affiliation: Department of Surgery, Fujinomiya City General Hospital, Shizuoka, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Kimura
authors.forename: Kennji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Umehara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawabe
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Wada
mesh_terms: D001646:Bile; D001652:Bile Ducts / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*