Komplikationsmanagement nach Gallengangschirurgie

Translated title of the contribution: Complication management after bile duct surgery

J. Bednarsch, C. Trauwein, U. P. Neumann, T. F. Ulmer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Bile leakage and postoperative bile duct strictures or anastomotic stenosis after bilioenteric anastomosis are complex surgical complications, which are associated with increased morbidity and mortality. Detailed diagnostics and sophisticated decision-making is always requiered. Complex liver surgery (redo procedures, nonanatomic resections, etc.) and surgery involving the liver hilum or exposure of the intraparenchymal Glissonean sheath are risk factors for postoperative bile leakage. Bile leakage is defined as a bilirubin concentration at least three times greater than the serum bilirubin measured in an abdominal drainage on or after the third postoperative day or as the need for radiologic intervention because of biliary collection or relaparotomy for bile peritonitis. Therapeutic strategies for bile leakage comprise conservative watch and wait, interventional procedures (endoscopic or percutaneous biliary drainage) and relaparotomy and are selected based on the postoperative onset, output volume and anatomic localization of the bile leak. Conservative treatment and interventional procedures show a high success rate and should therefore be considered as the treatment of choice in most cases. In contrast to bile leakage, bile duct strictures and anastomotic stenosis are rarely observed after surgery and can usually be treated by interventional procedures. This review article discusses situation-dependent specific treatment of postoperative bile leakage as well as bile duct strictures and anastomotic stenosis in detail.

Translated title of the contributionComplication management after bile duct surgery
Original languageGerman
Pages (from-to)29-36
Number of pages8
JournalDer Chirurg
Issue number1
Early online date5 Nov 2019
Publication statusPublished - Jan 2020


  • Bile leakage
  • Bile duct strictures
  • Endoscopic retrograde cholangiopancreatography
  • Percutaneous transhepatic biliary drainage
  • Bilioenteric anastomosis

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