Q6. Which are the clinical, biochemical, and imaging investigations required for the postoperative diagnosis of BDI?

Statements:

6.1. We recommend a prompt investigation of patients who do not rapidly recover after LC, with alarm symptoms being fever, abdominal pain, distention, jaundice, nausea, and vomiting (depending on the type of BDI). Weak recommendation, low quality of evidence (GRADE 2C) 6.2. The assessment of liver function tests, including serum levels of direct and indirect bilirubin, AST, ALT, ALP, GGT, and albumin, is suggested in patients with clinical signs and symptoms suggestive of BDI after LC. In critically ill patients, the serum levels of CRP, PCT, and lactate may help in the evaluation of the severity of acute inflammation and sepsis and in monitoring the response to treatment. Weak recommendation, low quality of evidence (GRADE 2C) 6.3. Abdominal triphasic CT is suggested as the first-line diagnostic imaging investigation to detect intra-abdominal fluid collections and ductal dilation. It may be complemented with the addition of CE-MRCP to obtain the exact visualization, localization, and classification of BDI, which is essential for planning a tailored treatment. Weak recommendation, moderate quality of evidence (GRADE 2B)