[Biliary fistula and bleeding after cholecystectomy].

The authors analysed 303 cases of cholecystectomy performed in their hospital and found that there were 22 cases of biliary fistula (7.2%), subhepatic infection ensued in 3 (0.9%), and massive postoperative bleeding in 5 (1.7%) with two deaths. The histology of the gallbladder bed was studied under microscope in 60 bodies. It was found that the intact gallbladder bed, rich in collagenous, elastic, and reticular fibers was a strong fibromembranous lining adhering to the liver surface, with numerous small blood vessels, bile ductuli, and lymphangiomas going through it. Leaving the lining intact and through and through sutures of any bleeding spots during the process of cholecystectomy and routine drainage of the subhepatic space were suggested by the authors in order to prevent postoperative bile leakage and bleeding.