CHOLESCINTIGRAPHY IN THE DIAGNOSIS OF THE COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY

Cholescintigraphy has been used to diagnose postoperative bile leaks and obstructions after open cholecystectomy. This imaging technique has been found to be sensitive for detecting bile leaks that arise from cholecystectomy and defects in the filling and emptying of bile ducts. These observations can be applied to patients who are suspected of having bile duct injury after laparoscopic cholecystectomy. Cholescintigraphy can detect a variety of bile leaks including those arising from the gallbladder fossa, cystic duct, and the common bile duct. In addition, cholescintigraphy can be used for management of patients after stenting or bypass surgery, to assess bile flow and operative sites for any residual bile leaks. Postoperative bile duct obstructions can also be seen with cholescintigraphy. In this article we discuss a comprehensive postoperative strategy for the management and diagnosis of biliary defects after laparoscopic cholecystectomy with cholescintigraphy. © 1993 W.B. Saunders Company. All rights reserved.