Diagnosis and Management of Postoperative Biliary Leaks

Postoperative biliary leaks have become more common in the past three decades since the development of laparoscopic biliary surgery. The role of the radiologist and interventional radiologist is important in the diagnosis and treatment of such complications, and can play an adjunctive role in the definitive surgical repair. Ultrasound, computed tomography, magnetic resonance cholangiopancreatography, nuclear medicine cholescintigraphy studies, and percutaneous transhepatic cholangiograms (PTC) are the various imaging modalities used for diagnosis. Interventional radiology treatment involves percutaneous drainage of bilomas, characterization of the biliary tree and assessment of the site of ductal injury with PTC, and biliary diversion with external biliary drainage.