Abstract

Purpose: A prospective study to evaluate post cholecystectomy problem management.

Patients & Methods: From Mars 2005 - April 2007, 210 patients were managed using endoscopy, percutaneous approaches, and surgery.

Results: Endoscopy was therapeutic in 183 cases {stones (81), stricture (55), leakage (35)}, and only diagnostic in 24.

Percutaneous approaches were done in 34 cases as diagnostic in 19 cases, stenting in 2 cases, and combined with endoscopy in 13 cases.

Surgery was done in 40 cases either urgent in 10 cases (4.8%), or planned in 30 cases (14.3%), for peritoneal lavage in 7 cases, choledocho-lithotomy in 8 cases, undo ligation and T-tube drainage in 5 cases, CBD repair splinted by T tube in 3 cases, choledocho-duodenostomy in 1 case, and Roux-en Y choledocho - jejunostomy in 18 cases.

Conclusion: Endoscopy is effective and safe not only diagnostic, but also therapeutic, especially when combined with percutaneous approaches that help in failure cases, but surgery remains the gold standard treatment not only for cases failed to be treated by less invasive approaches, but in cases mandatory to be explored as peritonitis.