Biloma after laparoscopic cholecystectomy

Abstract

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.