The mystery of post-cholecystectomy persistent bile leak: a case report | [Journal of Pakistan Medical Association • 2023]

Author(s):

1. Osama Shakeel: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

2. Muhammad Haroon: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

3. Muhammad Imran Khan: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

4. Ahmed Siddique Ammar: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

5. Muhammad Atiq: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

6. Faisal Hanif: Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan

Abstract:

Laparoscopic cholecystectomy (LC) is commonly performed for benign gallbladder diseases. Biliary leak is the most common complication of bile duct injury following this surgery. We report a case of persistent bile leak following the procedure despite endoscopic and radiological management. A female patient presented to the hepatopancreatobiliary unit of the Bahria International Hospital (Orchard), Lahore, with complaint of persistent bile leakage after laparoscopic cholecystectomy performed elsewhere. She had been investigated in various hospitals but the cause of the persistent bile leak remained a mystery and she was offered surgery. After real time fluoroscopic contrast enhanced imaging, further confirmed by a Computerised Tomography (CT) Scan of the abdomen, it was revealed that the persistent bile leak in the drain was due to iatrogenic injury of the duodenum secondary to percutaneous catheter insertion. The patient was managed non-surgically. She remained stable. This is a rare complication of one of the most common surgical procedures performed in the world.

Page(s): 671-673

DOI: 10.47391/JPMA.4848

Published: Journal: Journal of Pakistan Medical Association, Volume: 73, Issue: 3, Year: 2023

Keywords:

Laparoscopic cholecystectomy , Case report , Gallbladder , Bile leak

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