5 days after CBD surgery there is a small leak. What will be the best T/t -
Ans is 'b' ie ERCP and stenting If there is small leak after CBD surgery they are well managed by placing a stent in the bile duct through ERCP. A drain is placed in the subhepatic space percuntaneously. Small leaks resolve spontaneously. As explained in previous answers, a small leak may resolve by itself and need only aspiration of any collection. If it does not, then an ERC (or FTC) is advised to detect the site and extent of injury and managed accordingly. Since much information is not provided in the question we would opt for option 'b'. Also know - Bile duct injuries are more common with laproscopic than open cholecystectomy.
Ultrasound guided aspiration
ERCP and stenting
Re-exploration and hepatojejunostomy
Re-exploration and primary repair.