Use of oversized clip for ligation of cystic duct,surgeons beware!! Can give sleepless nights later on.

Kusum Meena; Sujata Singla; Brijesh Singh

Volume : VIII, Issue : IX, September - 2018

Use of oversized clip for ligation of cystic duct,surgeons beware!! Can give sleepless nights later on.

Kusum Meena, Sujata Singla, Brijesh Singh

Abstract :

Background

The overall incidence of billiary complications have come down remarkably low over the time due to refined knowledge of anatomy,revolutionary development of laparoscopic instruments and accessories.Bile leakage is not an unfamiliar situation for surgeons who are routinely performing laparoscopic cholecystectomies.

Case Report

Here we are reporting 3 cases relatively simple to perform but subsequently developed bile leak and formation of billioma.When retrospectively analized cause found was use of oversized clips to ligate cystic duct.

The postoperative bile leak significantly add to the morbidity and mortality of patients.

Conclusion

The purpose of reporting these cases is just to ing attention of all surgeons to this preventable cause of bile leak. Use of appropriate size of clips according to diameter of cystic duct to ligate is mandatory to avoid chances of slippage.The standard management is percutaneous drainage of billioma,ERCP Sphincterotomy and stenting.