A Serious Complication Following Laparoscopic Cholecystectomy: A Giant Biloma Causing Acute Abdomen

Year 2020, , 281 - 283, 25.06.2020

Abdussamed Vural , İsmail Altıntop

https://doi.org/10.16899/jcm.725438

Cited By: 1

Abstract

Possible complications are rare after laparoscopic cholecystectomy. Infection, bleeding and damage to the biliary tract complications are among these. A biloma is a well-demarcated, encapsulated or not,intrahepatic or extrahepatic bile collection secondary to iatrogenic, traumatic or spontaneous injury of the biliary tree. Laboratory findings are nonspecific. The diagnosis is usually suspected on the basis of a typical history (right upper quadrant abdominal pain, fever and recent abdominal trauma or surgery) and is confirmed by detection of typical radiologic features.
With this case report, we wanted to emphasize that in acute abdominal etiology, a surgical biloma that may develop after laparoscopic cholecystectomy should also be considered.

Keywords

: Biloma, laparoscopic cholecystectomy, postoperative complications

Laparoskopik Kolesistektomi Sonrası Gelişen Ciddi bir Komplikasyon: Akut Batına Neden Olan Dev Biloma

Abstract

Laparoskopik kolesistektomi sonrası gelişebilecek komplikasyonlar nadirdir. Enfeksiyon, kanama ve safra yolları hasarı bu komplikasyonlar arasında sayılabilir. Biloma, safra yollarının travmatik veya spontan hasarı sonrası intrahepatik veya ekstrahepatik yerleşim gösterebilen içi safra dolu iyi sınırlı, kapsüllü ya da kapsülsüz kistik bir lezyonudur. Laboratuvar bulguları spesifik olmayan bu hastalığın teşhisi tipik öykü (sağ üst kadran ağrısı, ateş, geçirilmiş cerrahi veya abdominal travma öyküsü ) ve doğrulayıcı radyolojik görüntü ile konur.
Biz bu olgu sunumu ile akut karın etiyolojisinde laparoskopik kolesistektomi işlemi sonrasında gelişebilecek cerrahi bir bilomanın da düşünülmesi gerektiğini vurgulamak istedik.

Keywords

Biloma, laparoskopik komplikasyon olan kolesistektomi, post operatif komplikasyonlar, reoperasyon

References

• 1. Gould L, Patel A. Ultrasound detection of extrahepatic encapsulated bile: "biloma". Am J Roentgenol. 1979;132:1014–5.
• 2. Nakajima N, Taira T, Omine M, et al. A case of spontaneous biloma accompanied with incarcerated choledocholithiasis. Nippon Geka Gakkai Zasshi. 1993;94(4):412–5.
• 3. Eubanks WS, Swanstorm LL, Soper NJ. Mastery of Endoscopic and Laparoscopic surgery. Lippincott Williams and Wilkins; 1999.
• 4. Kozarek R, Gannan R, Baerg R, Wagonfeld J, Ball T. Bile leak after laparoscopic cholecystectomy. Diagnostic and therapeutic application of endoscopic retrograde cholangiopancreatography. Arch Intern Med. 1992;152(5):1040–3.
• 5. Walker AT, Shapiro AW, Brooks DC, Braver JM, Tumeh SS. Bile duct disruption and biloma after laparoscopic cholecystectomy: imaging evaluation. Am J Roentgenol. 1992;158(4):785–9.
• 6. Carroll BJ, Birth M, Phillips EH. Common bile duct injuries during laparoscopic cholecystectomy that result in litigation. Surg Endosc. 1998;12:310–4. doi: 10.1007/s004649900660
• 7. Nordin A, Halme L, Mäkisalo H, Isoniemi H, Höckerstedt K. Management and outcome of major bile duct injuries after laparoscopic cholecystectomy: from therapeutic endoscopy to liver transplantation. Liver Transpl. 2002;8:1036–43.
• 8. Lee CM, Stewart L, Way LW. Postcholecystectomy Abdominal Bile Collections. Arch Surg. 2000;135:538–44. doi: 10.1001/archsurg.135.5.538.
• 9. Sgourakis G, Lanitis S, Korontzi M, Kontovounisios C, Zacharioudakis C, Armoutidis V, Karaliotas C, Dedemadi G, Lepida N, Karaliotas C. Incidental findings in focused assessment with sonography for trauma in hemodynamically stable blunt trauma patients: speaking about cost to benefit. J Trauma. 2011;71:E123–7.
• 10. Esensten M, Ralls PW, Colletti P, Halls J. Posttraumatic intrahepatic biloma: sonographic diagnosis. AJR Am J Roentgenol. 1983;140:303–5.
• 11. Lee NK, Kim S, Lee JW, Lee SH, Kang DH, Kim GH, Seo HI. Biliary MR imaging with Gd-EOB-DTPA and its clinical applications. Radiographics. 2009;29:1707–24.
• 12. Bas G, Okan I, Sahin M, Eryılmaz R, Isık A. Spontaneous biloma managed with +endoscopic retrograde cholangiopancreatography and percutaneous drainage: a case report. J Med Case Rep. 2011;5:3.
• 13. Vazquez JL, Thorsen MK, Dodds WJ, Quiroz FA, Martinez ML, Lawson TL, Stewart ET, Foley WD. Evaluation and treatment of intraabdominal bilomas. AJR Am J Roentgenol. 1985;144:933–8.