To explore the therapeutic strategy and efficacy of bile leakage after hepatobiliary surgery.

Clinical data of 73 patients with bile leakage after hepatobiliary surgery admitted to Gansu Provincial Hospital from January 2010 to August 2018 were retrospectively analyzed. Among them, 35 patients were male and 38 female, aged from 21 to 75 years with a median age of 56 years. The informed consents of all patients were obtained and the local ethical committee approval was received. The incidence of bile leakage, treatments and clinical efficacy were observed.

A total of 12 780 patients underwent hepatobiliary surgery in the same period. The incidence rate of bile leakage was 0.57% (73/12 780). 32 patients suffered from bile leakage after laparoscopic cholecystectomy, and 23 cases after laparoscopic choledocholithotomy, 11 cases after choledochojejunostomy and 7 cases after hepatectomy.15 cases were treated with double-cannula vacuum douche and drainage, 8 received percutaneous transhepatic cholangiodrainage (PTCD) combined with ultrasound-guided abdominal puncture and drainage, 4 were treated with endoscopic nasobiliary drainage (ENBD) and 1 received encoscopic retrograde cholangio-pancreatography (ERCP). All patients were cured. 17 cases were treated with simple abdominal drainage, in which 13 were cured. 18 cases received ultrasound-guided abdominal puncture and drainage, and 16 were cured. 10 cases underwent secondary operation, and 8 were cured. The total cure rate was 89% (65/73). Treatments in 8 cases failed, in which 1 case died of abdominal hemorrhage after the secondary operation.

The incidence of bile leakage after hepatobiliary surgery remains relatively high. The location and severity of bile leakage should be determined as early as possible. It is highly recommended to choose minimally invasive treatment to avoid the secondary surgery.