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Left lateral sectionectomy eliminated the source of bile leak, and the surgery was completed with abdominal cavity lavage.
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During the first ERCP procedure, a cholangiography was obtained to document evidence of biliary leakage, as well as the site and grade of the bile leak and to determine whether there was an associated major injury of the bile duct, namely a bile duct stricture resulting from direct surgical trauma.
A different and more recent technique is to use a covered stent that can close the bile leak and subsequently be retrieved percutaneously.
It is also used for exophytic tumours where thermal damage to the capsule can cause intraperitoneal bleeding or a bile leak, and for tumours that lie adjacent to blood vessels to avoid the heat sink phenomenon.
The majority of studies described only serious postoperative morbidity, the most common being bile leak and associated perihepatic abscess.
Several methods, namely nasobiliary drains or plastic stents, with or without sphincterotomy and biliary sphincterotomy alone, seem to be equally effective in facilitating the healing of a bile leak, and each method has its own limitations and advantages [ 5, 8, 25].
Given the proximity of the pancreatic anastomosis, a differential diagnosis between bile leak and pancreatic fistula based only on imaging findings is almost impossible.
The back wall of the cyst was checked carefully for evidence of a bile leak, and it was incinerated using an inverse-opal-structure electrode while avoiding Glisson's capsule (Fig. 2c).
Another consequence of injury is a posttraumatic bile leak, and a high-volume biliary fistula can hamper patient's recovery seriously [2].
Significant biliary complications included 2/107 (1.9%) cases of bile leak and 3/107 (2.8%) biliary strictures.
One patient in the non-statin group was re-operated two times: first because of bile leak and again because of abscesses.
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