Prevention of bile leak after liver surgery: a fool-proof method.
OBJECTIVE
Bile leak is not uncommon after liver surgeries. There is no adequate method described to prevent this morbid complication.


METHODS
At the end of the liver procedure, transcystic normal saline was injected under pressure with distal clamping. Leaking saline on the cut surface of the liver was sutured. The process was repeated till no leaking was observed. A suction drain was kept for any bile leak.


RESULTS
Open liver resection and hydatid cyst surgery cases were included. There were 24 cases, with 13 males and 11 females. The age range was from 4 to 80 years, with a mean of 48 years (SD +/- 17.7). The number of leak sites that could be sutured were 0-4 (mean of 2.3 +/- 0.5). None had bile leak postoperatively.


CONCLUSIONS
Transcystic injection under pressure with distal clamping demonstrates the leak sites. Suturing them prevents the postoperative bile leak.
Pujahari
Aswini K
AK
Department of Surgery, Armed Forces Medical College, Pune, India. akpuja@rediffmail.com