Bile Leak After Gallbladder Surgery & Biliary Reconstruction (2024)

FAQs

Bile Leak After Gallbladder Surgery & Biliary Reconstruction? ›

Bile leaks are a rare but serious complication of gallbladder surgery. If a bile duct is damaged during surgery, bile may leak into the abdominal cavity, causing extreme pain. Bile leaks are often corrected by placing a stent (narrow tube) in the duct to keep bile from escaping while the duct heals.

Bile leak usually presents within the first week but can manifest and be diagnosed up to 30 days after surgery; symptoms are unspecific and could be related to other postoperative complications [4,6]. Clinical manifestations of bile leak include persistent abdominal tenderness, generalized malaise and anorexia.

Treating Leaks in the Biliary System

The doctor passes the tube through the mouth and into the stomach, then injects a contrast dye into the ducts to view the bile ducts, which can be seen on x-ray. Special tools can be guided through the endoscope to insert a stent to stop the leak.

If the hole is too far in, the bile duct peripheral to the catheter may become obstructed and leak along the course of the catheter. A careful cholangiogram and meticulous tube placement solve these problems. Another common cause of leakage is clogging of the side-holes of the catheter with viscous bile.

A biliary leak can cause biloma, abscess, wound infection, intraabdominal infection, and sepsis.

Signs and Symptoms of Bile Duct Leaks

Jaundice, which is the yellowing of the skin and eyes. Nausea. Severe abdominal pain. Vomiting.

In our experience, drainage of 200 ml or less of bile per day, and reducing over a period of a few days, is likely to subside on its own. In some cases, this may be all that is necessary and the bile leak will slowly reduce and stop.

A leaking bile duct is considered a medical emergency, as it can be deadly if not treated. If you have certain risk factors, such as a recent gallbladder surgery, and are experiencing possible symptoms of a biliary system issue, see a doctor right away.

The clinical presentation of a patient with a postoperative biliary leak may include right upper quadrant pain, nausea, vomiting, anorexia, and fever. Laboratory findings may include leukocytosis and abnormal liver function tests.

The antibiotics most often used in cases of biliary peritonitis are piperacillin/tazobactam, imipenem/cilastatin, meropenem, ertapenem, or aztreonam associated with amikacin in cases of associated shock and fluconazole in cases of fragility or delayed diagnosis.

How often should I flush my biliary drain? ›

You must flush your catheter with normal saline 2 times every day. Your IR doctor will tell you if you should use 3 mL, 5 mL, or 10 mL of saline.

The cut surface of the liver with associated cut bile duct is a significant source of bile leak. Many leaks are small and will resolve without intervention. Larger leaks can result in abdominal pain, bile peritonitis, abscess, or abdominal sepsis. The large symptomatic leaks can be high as 40% to 50%.

In our retrospective series of 643 cancer patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD), the median overall survival was 2.6 months [5].

Bile leaks are a rare but serious complication of gallbladder surgery. If a bile duct is damaged during surgery, bile may leak into the abdominal cavity, causing extreme pain. Bile leaks are often corrected by placing a stent (narrow tube) in the duct to keep bile from escaping while the duct heals.

Nasobiliary tube placement is an alternative treatment for bile leaks, with the advantage of insertion without sphincterotomy, and can be removed without follow-up endoscopy. In addition, nasobiliary drains allow for serial noninvasive cholangiog- raphy to document healing and to allow earlier tube removal.

In many cases, a cut or clipped bile duct is a serious form of medical malpractice. Medical malpractice takes place when a medical professional causes injury by deviating from the appropriate standard of care.

Some of the symptoms that are associated with this include: Persistent pain and discomfort. Nausea and/or vomiting. Fever.

The symptoms include fatty food intolerance, nausea, vomiting, heartburn, flatulence, indigestion, diarrhea, jaundice, and intermittent episodes of abdominal pain.[2] Post-cholecystectomy syndrome can present early, typically in the post-operative period, but can also manifest months to years after surgery.

The answer is almost certainly yes. But injury from cutting the common bile duct is often the result of medical malpractice. As any malpractice lawyer will tell you, it is the same surgeons who are “frequent flyers” in malpractice claims involving common bile duct injuries.

Symptoms include biliary or non-biliary-like abdominal pain, dyspepsia, vomiting, gastrointestinal disorders and jaundice, with or without fever and cholangitis [1, 2].