Final answer:
For a postoperative fever and abdominal pain due to a cystic duct stump leak after a cholecystectomy, the next step is typically an endoscopic attempt to manage the leak, with procedures like stenting or sphincterotomy during an ERCP. If these are unsuccessful, surgical intervention might be needed.
Step-by-step explanation:
Clinical Focus: Postoperative Management
A 40-year-old man experiencing a postoperative fever and abdominal pain after a laparoscopic cholecystectomy likely represents a complication from the surgery. A Hepatobiliary Iminodiacetic Acid (HIDA) scan has shown a leak, and this was confirmed with evidence of a cystic duct stump leak on an Endoscopic Retrograde Cholangiopancreatography (ERCP). Since ERCP has not only confirmed the leak but also provides therapeutic intervention capabilities, the next step would typically involve an endoscopic attempt to address the leak, which may include procedures such as stenting or sphincterotomy to manage the leakage and promote healing. In the case where endoscopic management is unsuccessful or the patient's condition worsens, surgical intervention may be necessary.