A 40 year old patient has undergone an Open cholecystectomy. The procedure was repoed as uneventful by the operating surgeon. She has 100ml of bile output from the drain kept in gallbladder bed on the first postop day. On. Examination she is afebrile and anicteric. The abdomen is soft and bowel sounds are normally heard. As an attending physician, what should be your best possible advice
A small amount of biliary drainage following cholecystectomy should cause no alarm because it usuly disappears within 1 or 2 days. However, excessive biliary drainage through the wound or drain site, jaundice, sepsis or a combination of these events early in the postoperative periods should suggest a bile duct injury, as should copious biliary drainage for more than few post op days Ref : Sabiston 20th edition Pgno :1503
Order an urgent endoscopic Retrograde cholangiography and biliary stenting
Urgent laparotomy
Order an urgent hepatic imino diacetuc acid scintigraphy (HIDA)
Clinical observation
G.I.T