Etiology, Diagnosis, and Management of Bilomas: A Current Update

Copelan, Alexander; Bahoura, Lawrence; Tardy, Frances G.; Kirsch, M.; Sokhandon, Farnoosh; Kapoor, Baljendra

doi:10.1053/j.tvir.2015.07.007

Cited by 53 publications

(93 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On US images, bilomas present as well-circumscribed, anechoic and encapsulated masses with or without internal debris and septa (7,12). However, a variety of intraperitoneal cystic lesions have overlapping features, including hematoma, hepatic cyst, abscess and pseudocyst.…”

Section: Discussionmentioning

confidence: 99%

“…Iatrogenic biliary injury, particularly cholecystectomy, is the predominant causative factor, followed by blunt abdominal injury (12,13). In certain cases, spontaneous biloma formation may occur, and this is usually associated with bile duct disruption, but rarely with GBP (13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…Jaundice, nausea and vomiting are often present as a result of extrinsic compression of the biliary or digestive system, whereas certain patients may be asymptomatic. Laboratory findings consist of leukocytosis with neutrophilia and liver dysfunction, although the values obtained may be non-specific, and a few patients have no abnormalities at the time of diagnosis (12).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis. GBP is subdivided into three categories whereas the development of biloma is extremely rare. The present case study reports on a 40-year-old man with a 10-year history of calculus cholecystitis, who was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for the surgical treatment of an emerging massive hepatic entity with insidious symptoms and normal laboratory tests. A preoperative imaging study demonstrated the collection with internal septations and mural nodules, but no visible communication with the biliary system. Given the suspected biliary cystic tumor, a laparotomy was performed and the lumen was scattered with papillae. An intraoperative frozen section examination illustrated a simple hepatic cyst. Biochemical analysis of the collection and histopathology of the gallbladder and capsule substantiated the diagnosis of biloma formation due to GBP. The purpose of the present case report was to demonstrate how a pinhole-sized perforation with extravasation of unconcentrated bile from the gallbladder may result in insidious clinical presentation and an undetected leak site. According to the clinicopathological characteristics and composition, formation of biloma should be classified as type IV GBP. To differentiate bilomas with intracystic septations and mural nodules from BCTs is difficult via a preoperative examination, and the definitive diagnosis should be based on a histological examination. Laparotomy with frozen section examination may be the optimal approach in such a case.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…2 Biliary leaks may occur within one-week postoperatively, but delayed clinical presentation may occur up to one month postoperatively. 3,4 An important factor that one must have into account and that can increase the risk of biliary leakage, are the variations in biliary anatomy which are very common. It is estimated that around 19% to 39% of the population have a variation of the "normal" biliary anatomy.…”

Section: Introductionmentioning

confidence: 99%

Minimal invasive treatment of biliary leak after laparoscopic cholecystectomy

Acquafresca

2019

Gastrointestinal Intervention

View full text Add to dashboard Cite

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.

show abstract

“…The rate at which the abdominal peritoneum absorbs bile can determine the size and even location of the biloma. 5,7,8,11 Biliary leaks and bilomas can occur from traumatic injury or iatrogenic injury, such as laparoscopic cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), radiofrequency ablation of hepatic tumors, and liver biopsy. Postcholecystectomy leaks can occur from injury to the common bile duct, cystic duct stump, or small ducts that drain from the gallbladder fossa directly into the biliary system, known as accessory ducts of Luschka.…”

mentioning

confidence: 99%

Diagnosis and Management of Postoperative Biliary Leaks

Nikpour

Knebel

Cheng

2016

Semin intervent Radiol

View full text Add to dashboard Cite

Postoperative biliary leaks have become more common in the past three decades since the development of laparoscopic biliary surgery. The role of the radiologist and interventional radiologist is important in the diagnosis and treatment of such complications, and can play an adjunctive role in the definitive surgical repair. Ultrasound, computed tomography, magnetic resonance cholangiopancreatography, nuclear medicine cholescintigraphy studies, and percutaneous transhepatic cholangiograms (PTC) are the various imaging modalities used for diagnosis. Interventional radiology treatment involves percutaneous drainage of bilomas, characterization of the biliary tree and assessment of the site of ductal injury with PTC, and biliary diversion with external biliary drainage.

show abstract

Etiology, Diagnosis, and Management of Bilomas: A Current Update

Cited by 53 publications

References 33 publications

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Minimal invasive treatment of biliary leak after laparoscopic cholecystectomy

Diagnosis and Management of Postoperative Biliary Leaks

Contact Info

Product

Resources

About