Atlas of Gastroenterological Endoscopy
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Biliary leak after cholecystectomy
Biliary leakage with stone Biliary leakage
Postoperative occurence of a severe colic attack at the right upper quadrant. The left x-ray shows a prepapillary concrement. At the same time contrast medium reaches the free abdominal cavity. The right shot shows the leakage from the the site of the removed gall bladder explaining the peritoneal contrast- enhancement. The clips at the stump of the cystic duct are tightly fixed, since there is no obvious leakage.
Move the mouse´s arrow onto the x-ray images to outline the leakage.
Stent with 4 flaps at each side The stone can be removed after EPT. A plastic stent is inserted for 4 weeks to secure the biliary flow, thus facilitating closure of the leakage. Normally biliary leaks including leaks from an open cystic duct, close spontaneously after a short while. In case of obstruction the leak is kept open by the raised intraductal pressure. Simple drainage or removal of the obstruction prevents a relaparotomy.