Challenges in the diagnosis and management of spontaneous bile duct perforation: A case report and review of literature

Faridi, Shahbaz Habib; Aslam, Mohammed; Siddiqui, Bushra; Khan, Rizwan

doi:10.4103/0971-9261.159030

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…The experience of the surgical team is one of the most important factors in the management of patients with bile leakage ( 13 , 14 ). In our institute, the management of bile leakage has evolved after the introduction of the ISGLS definition, preferring a wait-and-see approach ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Strict Surgical Repair for Bile Leakage Following the Roux-en-Y Hepaticojejunostomy

Zhang

Gao

et al. 2021

Front. Surg.

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Background: The optimal bile leakage management strategy in the pediatric population following the initial Roux-en-Y hepaticojejunostomy is still a matter of discussion today. Here, we assessed the roles of bile leakage management and surgical implementation on outcomes for patients with bile leakage.Materials and Methods: A revised protocol for bile leakage management with restricted surgical intervention was implemented at Chongqing Children’s Hospital on March 15, 2013 and Sanxia Hospital on April 20, 2013. We performed a retrospective, historical control analysis for the protocol implementation to compare the short- and long-term outcomes using the corresponding statistical methods.Results: There was a total of 84 patients included in the analysis, including 46 patients in the pre-protocol group and 38 patients in the post-protocol group. No statistical differences for the demographic features were found between the two groups. There was a decrease in redo surgeries in the post-protocol cohort compared to those in the pre-protocol cohort (odds ratio [OR] = 4.48 [95% CI, 1.57–12.77]; p = 0.003). Furthermore, patients in the post-protocol group were less likely to be associated with intensive care unit (ICU) admission (OR = 3.72 [95% CI, 1.11–12.49]; p = 0.024) compared to patients in the pre-protocol group, respectively. There was no mortality between the two groups.Conclusions: A restrictive surgical intervention strategy can effectively reduce the rate of redo surgery and exhibited promising outcomes for bile leakage in terms of postoperative recovery and hospitalization costs.

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Section: Discussionmentioning

confidence: 99%

Strict Surgical Repair for Bile Leakage Following the Roux-en-Y Hepaticojejunostomy

Zhang

Gao

et al. 2021

Front. Surg.

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“…The most common surgical intervention involves washout and drainage of the abdominal cavity with closure of the duct perforation around a T-tube if the duct has been transected or ERCP is not available. 3 …”

Section: Discussionmentioning

confidence: 99%

Primary Bile Duct Perforation Associated with Pancreatitis

Gerrard

Thind

Date

2018

ACG Case Reports Journal

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Primary bile duct perforation is rare in adults. It commonly results in biliary peritonitis and high morbidity and mortality. We present a 72-year-old man who was initially admitted with biochemically diagnosed pancreatitis who was found to have a bile duct perforation and bile collection limited to the lesser sac. This presented a diagnostic challenge and, due to its containment, did not result in generalized biliary peritonitis, which is usually associated with this condition. His condition was managed with stenting with endoscopic retrograde cholangiopancreatography.

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“…The most frequent cause of spontaneous biloma is choledocholithiasis [15, 16]. However, several causes of spon¬taneous perforation of bile duct have been seen due to ero¬sion caused by biliary stones that injured the duct wall; increased intraductal pressure due to an obstruction of the distal bile duct (by stones, carcinomas, or a reflux spasm of the sphinc¬ter of Oddi); thrombosis of a vessel supplying the bile duct wall; intramural infection of the duct as a result of cholangitis; regurgitation of pancreatic secretions into the bile duct; diverticulitis of the bile duct; and acute pancreatitis [17-19]. Bilomas are generally localized in the right upper quadrant of the abdomen, neighboring the right hepatic lobe [16].…”

Section: Discussionmentioning

confidence: 99%

Non postoperative biloma in Mauritania: case report and literature review

Idriss¹,

Tfeil²,

Baba³

et al. 2018

Pan Afr Med J

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Biloma is used to describe abnormal accumulation of bile outside biliary tract. It is a very rare condition with extrahepatic diffused or encapsulated collection of bile, mostly post-operative or post traumatic. A 72-year-old woman was referred to our hospital with acute abdominal pain located in right upper quadrant. Clinical examination suspected abdominal collection. Imagery (ultrasound and computed tomography scan) demonstrated a large well-defined intra-abdominal collection. Percutaneous ultrasound guided drainage of abdominal collection revealed a bile fluid. Drain was removed a week later and complete resolution of symptoms was obtained in two weeks. Even in the absence of specific diagnostic indications, radiological images may play a key role in the evaluation of suspected biloma in patients with appropriate medical history and clinical characteristics.

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Challenges in the diagnosis and management of spontaneous bile duct perforation: A case report and review of literature

Cited by 7 publications

References 6 publications

Strict Surgical Repair for Bile Leakage Following the Roux-en-Y Hepaticojejunostomy

Strict Surgical Repair for Bile Leakage Following the Roux-en-Y Hepaticojejunostomy

Primary Bile Duct Perforation Associated with Pancreatitis

Non postoperative biloma in Mauritania: case report and literature review

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