Management of postcholecystectomy complications: role of interventional radiology

ABSTRACT

This study summarized diagnostic and therapeutic procedures in 26 patients who suffered postcholecystectomy complications. Complications were divided into bile stricture or ligation, retained stones and pathologic fluid collections. Specific lesions were bile duct stricture [n = 11], accidental bile duct ligation [n = 3], retained stones [n = 7], abscess [n = 4] and biloma [n = 1]. Presenting problems were right upper abdominal pain, sepsis, jaundice and intermittent cholangitis. The patients underwent 37 interventional radiologic procedures including 14 percutaneous transhepatic cholangiograms [PTC], 4 percutaneous biliary drainage [PBD], 4 T-tube cholangiography, 3 endoscopic retrograde cholangiopancreatography [ERCP], 7 endoscopic sphincterotomy [ES] and stone extraction, and drainage of 4 abscesses and one biloma. Ten [38%] patients did not need further surgical intervention, while in the remaining 16 patients who underwent reoperation, the procedures helped to establish the diagnosis, improve the patient's preoperative status, or to serve as a landmark for the surgeon to locate and repair the ligated or strictured duct. Interventional radiologic procedures were found helpful to cure the complication and obviate reoperation, improve the general conditions of the patient and provide an adequate guide for bile duct reconstruction