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Treatment of bile leaks: leakage of bile into the abdominal cavity is a complication of laparoscopic cholecystectomy. The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure gradient between the bile duct and the duodenum, encouraging transpapillary bile flow and allowing the leak ...
ERCP may provoke hemobilia from trauma to friable hilar tumors or a guide-wire penetrating the bile duct wall, creating a biliary fistula. Delayed bleeding is a rare but potentially serious complication of sphincterotomy, particularly as many patients are discharged home within hours of ERCP.
First lines of treatment can include mass spectrum antibiotics or drainage of the bile duct that is infected followed by close monitoring. [7] Endoscopic surgery is favored over open procedures to reduce infection and quicker recovery times. If these fail a liver transplant may be necessary. [citation needed]
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus choledocho-+ lithiasis). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP).
For diagnosis, measures of liver biochemistry and pancreatic enzymes are performed. Along with ruling out structural abnormalities, normally by performing an abdominal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). Measurements of bile transit when performing ERCP are taken to help evaluate different treatment options. [5]
Such patients usually present with bilioptysis (presence of bile in sputum), persistent cough, chest infections, or respiratory distress due to pleural effusion. Bilioptysis is the pathognomonic clinical feature of BBF. [1] Extensive ascites may accumulate, especially in the setting of sterile bile leakage, which is often asymptomatic in nature.
A biloma is a circumscribed abdominal collection of bile outside the biliary tree. [1] It occurs when there is excess bile in the abdominal cavity. It can occur during or after a bile leak. There is an increased chance of a person developing biloma after having a gallbladder removal surgery, known as laparoscopic cholecystectomy.
A biliary stricture, leak, or obstruction may be the injury's outward manifestation. A history of gallbladder empyema or gangrenous cholecystitis as reasons for cholecystectomy should raise the possibility of biliary injury. If the bile duct injury is not recognized right away, the patient may present with bile in the drain, if one was left in ...