Minimally invasive interventions in the treatment of intra-abdominal bile leakage after cholecystectomy

Abstract

Aim. To study the advantages of using minimally invasive methods for the surgical correction of intra-abdominal bile leakage (IABL) that developed after cholecystectomy.
Patients. The results of the examination and treatment of 49 patients with were studied and divided into
two groups. The comparison group included 22 (44,9%) patients operated on in 2001–2010, in the complex treatment of which standard generally accepted approaches were used. The main group included 27
(55,1%) patients operated on in 2011–2020, in whom minimally invasive surgical and endoscopic interventions were used as priority methods of surgical treatment.
Results. The frequency of IIB after cholecystectomy is 0,8%, while in more than half (57,2%) of cases,
the cause of this complication is the so-called «small» damage (failure of the cystic duct stump, damaged
Luschka passages, dislocation of the drainage from the hepaticocholedochus) which almost always (93,3%
of cases) can be corrected using puncture methods under ultrasound guidance, transduodenal endoscopic
interventions and laparoscopy, do not resort to wide relaparotomy.
Conclusion. Compliance with the principles of differentiated priority use of minimally invasive surgical/
endoscopic interventions in patients with after cholecystectomy helps to reduce the incidence of postoperative / post-procedural complications from 36,4 to 11,1% and minimize the risk of death in this formidable complication.