Recent cholecystectomy with fever and abdominal pain most strongly suggests which complication?

• A. Post-operative bile leak
• B. Retained stone
• C. Biliary stricture
• D. Pancreatitis

Answer: (A)

Immediately after cholecystectomy, fever with abdominal pain most strongly points to a bile leak into the peritoneal cavity. A leak typically arises from the cystic duct stump or an injured bile duct and irritates the peritoneum, producing chemical or infectious peritonitis with pain and fever. Other post-op issues like a retained stone cause obstruction later, often with jaundice or cholangitis rather than early diffuse abdominal pain; pancreatitis presents with a different pain pattern and timing, and biliary strictures tend to show up much later with progressive obstruction. So the combination of fever and abdominal pain right after surgery most directly signals a bile leak, necessitating prompt imaging and typically interventions to divert or seal the leak (such as ERCP with sphincterotomy and stenting, or surgical repair if necessary).