Extrahepatic biliary obstruction due to post-laparoscopic cholecystectomy biloma.
BACKGROUND
Jaundice presenting after cholecystectomy may be the initial manifestation of a serious surgical misadventure and requires rigorous diagnostic pursuit and therapeutic intervention. Biloma is a well recognized postcholecystectomy complication that often accompanies biliary ductal injury.


METHODS
A 23-year-old female underwent laparoscopic cholecystectomy for symptomatic gallstones and three weeks postoperatively developed painless jaundice. Radiographic and endoscopic studies revealed a subhepatic biloma causing extrinsic compression and obstruction of the common hepatic duct.


RESULTS
Percutaneous catheter drainage of the biloma combined with endoscopic sphincterotomy successfully relieved the extrahepatic biliary obstruction and resolved the intrahepatic ductal leak responsible for the biloma.


CONCLUSIONS
Although heretofore undescribed, postcholecystectomy jaundice due to extrahepatic bile duct obstruction caused by biloma may occur and can be successfully treated by means of standard radiologic and endoscopic interventions.
Department of Surgery, Queen of Angels-Hollywood Presbyterian Medical Center, California 90027, USA.
A Y
AY
Mansour
B E
BE
Stabile
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002769:Cholelithiasis / Q000601:surgery; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common; D006801:Humans; D012086:Reoperation; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D013396:Suction / Q000379:methods*; D014057:Tomography, X-Ray Computed