Int J Gastrointest Interv.  2019 Jan;8(1):45-48. 10.18528/ijgii180041.

Minimal invasive treatment of biliary leak after laparoscopic cholecystectomy

Affiliations
  • 1DAICIM Foundation, Buenos Aires, Argentina. pabloacquafresca@hotmail.com

Abstract

The laparoscopic cholecystectomy has become one of the most common operations for treatment of symptomatic gallbladder disease. However significant postoperative biliary duct injuries can occur, leading to biliary leaks. Here we present a case where multiple abdominal collections are detected in a 64-year-old male patient who underwent laparoscopic cholecystectomy due to gallbladder stones two weeks prior. Percutaneous drainage under computed tomography guidance is implemented to treat the collections which result to be bilomas. After controlling the leak, an endoscopic retrograde cholangiopancreatography with papillotomy and stent placement is performed believing that the problem was settled in the cystic duct. But after observing that the leak increased with this treatment, an anatomical variation is suspected. A percutaneous transhepatic cholangiography is performed which confirm the diagnosis. In case of any deviation of a normal surgical post operatory, a biliary leak must be suspected. Surgeons nowadays must be trained in different diagnosis and treatment methods.

Keyword

Bile ducts; Biliary fistula; Cholangiography; Cystic duct; Radiology, interventional

MeSH Terms

Bile Ducts
Biliary Fistula
Cholangiography
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy, Laparoscopic*
Cystic Duct
Diagnosis
Drainage
Gallbladder
Gallbladder Diseases
Humans
Male
Middle Aged
Radiology, Interventional
Stents
Surgeons
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