Background:

Bile leak is a rare complication after Laparoscopic Cholecystectomy. Subvesical bile duct (SVBD) injury is the second cause of minor bile leak, following the unsuccessful clipping of the cystic duct stump. The aim of this study is to pool available data on this type of biliary tree anatomical variation to summarize incidence of injury, methods used to diagnose and treat SVBD leaks after LC.

Methods:

English articles published between 1985 and 2021 describing SVBD evidence in patients operated on LC for gallstone disease, were included. Data were divided into two groups based on the intra or post-operative evidence of bile leak from SVBD after surgery.

Results:

This systematic report includes 68 articles for a total of 231 patients. A total of 195 patients with symptomatic postoperative bile leak are included in Group 1, while Group 2 includes 36 patients describing SVBD visualized and managed during LC. Outcomes of interest were diagnosis, clinical presentation, treatment, and outcomes.

Conclusion:

The management of minor bile leak is multidisciplinary. In 86% of cases, Endoscopic Retrograde Cholangio-Pancreatography (ERCP) was the preferred way to visualize and treat this complication. Surgery shouldn’t be considered as a first-line treatment and it is recommended when endoscopic or radiological approaches aren’t resolutive.