title: The Role of CT cholangiography in the Detection and Localisation of Suspected Bile Leakage Following Cholecystectomy.
abstract: BACKGROUND
  Most bile duct injuries are not recognized at the time of initial surgery. Optimal treatment requires early recognition. CT IVC has become increasingly important in identifying bile leaks and their source after cholecystectomy. Our study aims to report the outcomes of using CT IVC post operatively and how accurately it can detect or localise bile leaks.
  
  
  METHODS
  From 2000 - 2009, twenty patients were managed for suspected bile leak post cholecystectomy within the Alfred Hospital. The study included a retrospective evaluation of the initial procedure, presenting symptoms, site of ductal injury, diagnostic procedures and therapeutic interventions. Results were analysed to determine success of the imaging procedure, and to correlate imaging diagnosis with results both diagnostically and clinically.
  
  
  RESULTS
  Twenty patients had a suspected bile leak, of which 3 were detected at the time of surgery. Seven patients had a CTIVC as their primary investigation. It identified bile leak in 6 and the anatomical site in 5. One had a leak excluded and was managed conservatively.
  
  
  CONCLUSIONS
  CT Cholangiography is a feasible and low-risk tool for imaging of the biliary tract in suspected bile leaks post cholecystectomy. It is a valuable non-invasive investigation that may help avoid endoscopic retrograde Cholangiography or surgery.
authors: Department of Surgery, Frankston Hospital, Victoria, Australia.
authors: Michael
authors: M
authors: Kirk
authors: Department of Surgery, The Alfred Hospital, Victoria, Australia.
authors: Elan
authors: E
authors: Kaplan
authors: Department of Surgery, The Alfred Hospital, Victoria, Australia.
authors: Ruwangi
authors: R
authors: Udayasiri
authors: Department of Surgery, The Alfred Hospital, Victoria, Australia.
authors: Val
authors: V
authors: Usatoff
keywords: Bile leak; CT cholangiography; Cholecystectomy