Post cholecystectomy bile leak

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Bile in drain tube post laparoscopic cholecystectomy.

Patient Data

Age: 65 years
Gender: Female

Intravenous cholangiogram

ct

Large perihepatic low-density fluid collection. Drain tube. Post biliscopin there is extraluminal contrast adjacent to the cholecystectomy clips extending along the drain tube. No filling defect in the common bile duct. Vicarious renal excretion. 

Case Discussion

This patient was 7 days post elective laparoscopic cholecystectomy with persistent bile draining from the surgical drain. These can occur secondary to common bile duct injury but are most commonly from the cystic duct stump or subvesical ducts of Luschka. 

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