RESUMEN
To find out the causes and outcome of management in cases of bile leakage following cholecystectomy. Prospective descriptive study from April 2005 to December 2006. Surgical Unit five of Civil Hospital, Karachi. A total of 140 patients who were operated for symptomatic gall stones. Detailed information regarding the patients was collected. Initially due to non-availability of ERCP as well as high cost in the private sector, all patients with biliary leakage underwent open surgery. Later on all patients underwent ERCP due to its availability in the unit; operative intervention was only undertaken when the ERCP was not therapeutic or failed. Ultrasound studies were done in patients who were suspected to have bile collections but no discharge from the drains or the operative wounds. Out of 140 patients, two patients were noticed to have biliary leakage during surgery and 10 post-operatively. The former cases underwent repair on the spot, while in the latter group five underwent re-exploration and four ERCP; one patient expired without intervention and another from the re-exploration group. In three patients ERCP was successful and sphincterotomy with stenting was done while in one patient there was failure of cannulation, resulting in open exploration