40 year-old female underwent an uneventful laparoscopic cholecystectomy. Patient is discharge on post op. day#1.
Patient is re-admitted on post op day# 4 with chief complaint of right upper quadrant pain and shoulder pain (right). Abdomen soft, tender in RUQ. no peritoneal signs, BS+, BM+.
CT-Scann showed small peri hepatic collection.
Post op day# 5, Hbg: 8.7
Post op day# 6, Hbg: 7.9 Billi total: 1.6 Alk Phos: 300, pulse 80 BP 110/70, resp: 12. no orthopnea, urine output 300cc/8hs.
1- conservative: transfusion, diet, observe (for how long?)
repeat CT ? labs?
2- surgical: laparoscopy vs. open
I will appreciate any in-put on this case