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Had gallbladder removed, having bile leakage. Told that duct is sealed and can take time to stop leaking. Suggest?

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Gastroenterologist, Surgical
Practicing since : 1991
Answered : 52 Questions
I have a friend who had his gallbladder removed a few days ago and is now having bile leakage. According to the Dr the ducts have been sealed and it can take up to 3 weeks for them to stop leaking. Is this correct? Why are the ducts leaking?
He is leaking about 30cc's every 5 hours from one of his drains. I am worried about his liver and pancrease. I am thinking he needs a second opinion. The Dr he has said to wait and see if the leak stops over the weekend. I don't think waiting is the answer. What do you suggest? Also, what is your opinion on the medication Reglan?
Posted Fri, 20 Sep 2013 in Liver and Gall Bladder
Answered by Dr. Nitin Rao 2 hours later
Brief Answer:

Detailed Answer:

Bile leak is always a possibility after gallbladder surgery. The initial few days when the cut ends are not completely healed, bile leak is a very common phenomenon. Looking at the amount of leakage there is a very good possibilty that it may stop on its own.

I would also like to wait for some more days before considering other options. Should the leak continue another suggestion is to do an ERCP and sphincterotomy with or without stenting of the common bile duct.

Reglan is a prokinetic drug. It is can be used in this circumstances. In routine clinical practice we do not use it; we imply a wait and watch protocol.

Hope this helps. I will be available to for further assistance.

Take care
Above answer was peer-reviewed by
Follow-up: Had gallbladder removed, having bile leakage. Told that duct is sealed and can take time to stop leaking. Suggest? 4 hours later
With it being a holiday weekend I know that my friend will not be released form the hospital before tuesday. If he is still leaking bile then and the amound hasn't changed I will look into other options.
The Dr had mentioned the ERCP but stated that they can't do it at the hospital he is at and they would need to transfer him. Is it important that he get this done sooner than next week? His initial removal was 5 days ago. Went in for emergency surgery 3 days ago. They put the 2 drains in then. One of them seems to not be producing too much bile. The other doesn't seem to be slowing down production much at all.
THank you for your help. I am concerned about liver damage or worse because of what I have read about bile leaks etc.
Answered by Dr. Nitin Rao 15 hours later
Brief Answer:

Detailed Answer:
I am sure your doctor would be the best judge as to, when what is to be done.
Liver damage is not usually a problem in the initial period so please relax.
There is no fixed time when an ERCP is to be done so it is basically done on the decision of the treating physician.
Take care
Above answer was peer-reviewed by
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