Complications of Biliary Tract Surgery and Trauma

Gallbladder and biliary tract operations are among the most common abdominal procedures performed in the United States. Postoperative bile leaks after cholecystectomy may occur from any portion of the biliary tract. Patients with postoperative biliary leaks exhibit a wide range of clinical symptoms and signs. After biliary leaks, the common symptoms are abdominal pain, distension, nausea, vomiting, fever, and jaundice. Strictures arising from biliary surgery typically manifest themselves months to years after the initial procedure. Most benign biliary strictures occur after cholecystectomy. Historically some surgeons have repaired benign biliary strictures by using endoscopic dilatational techniques. Biliary micro-organisms, most frequently Escherichia coli, are usually responsible for wound infection. The diagnosis of biliary system injury is most frequently made intraoperatively. Biliary tract surgery and its associated complications can present difficult challenges in management. In general, iatrogenic injuries to the biliary tree occur more frequently than injuries that result from blunt or penetrating trauma.