Biloma after laparoscopic cholecystectomy

Authors T.E. Pavlidis, K.S. Atmatzidis, B.T. Papaziogas, I.N. Galanis, I.M. Koutelidakis, T.B. Papaziogas.


Purpose: Laparoscopic cholecystectomy has become the
standard method in the management of cholelithiasis. Subhepatic
bile collection or biloma is a relatively uncommon
complication, which is highlighted in this paper.
Methods-Results: Over the past two-year period the same
surgeon performed 180 laparoscopic cholecystectomies
without any intra-operative event. All patients but three had
an uneventful postoperative course (morbidity 1.6%). In 3
cases (women, 72-74-88 years-old) the US-scanning revealed
a sub-hepatic biloma manifested by persistent right upper
quadrant or epigastric pain, abdominal distention, fever
and leukocytosis. In one case there was co-existent gastric
outlet obstruction two weeks after the operation and mild
obstructive jaundice in another one. All were managed successfully
by drainage under ultrasound guidance and antibiotics,
prolonging the hospitalization.
Conclusions: Small bile leakage and biloma formation is a
rather unusual complication after laparoscopic cholecystectomy
that should be kept in mind.
Key words: Laparoscopy, Cholelithiasis, Laparoscopic cholecystectomy,
Complications, Biloma, Bile leakage
Case Reports