Pediatr Gastroenterol Hepatol Nutr.  2016 Dec;19(4):281-285. 10.5223/pghn.2016.19.4.281.

Post Laparoscopic Cholecystectomy Biloma in a Child Managed by Endoscopic Retrograde Cholangio-Pancreatography and Stenting: A Case Report

• Tiwari C
• Makhija OP
• Makhija D
• Jayaswal S
• Shah H

• KMID: 2364770
• DOI: http://doi.org/10.5223/pghn.2016.19.4.281

Abstract

Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP). However, surgical exploration is required in cases not responding to non-operative management. If not managed on time, such injuries can lead to severe hepatic damage. We describe a case of an eight-year-old girl who presented with biloma formation after laparoscopic cholecystectomy who was managed by ERCP.

Keyword

Cholecystectomy; Laparoscopic; Biloma; Child

MeSH Terms

Bile
Bile Ducts
Child*
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy
Cholecystectomy, Laparoscopic*
Drainage
Female
Humans
Stents*

Figure

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  Fig. 1 Clinical photograph showing lump in right hypochondrium and epigastrium.

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  Fig. 2 Abdominal computed tomography scan image showing a large collection of 10×9×8 cm encompassing stomach and left lobe of liver.

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  Fig. 3 Endoscopic retrograde cholangio-pancreatography showing small leak from the right posterior duct.

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