Cholangiographic demonstration of postoperative bile leakage from aberrant biliary ducts

Copious persistent postcholecystectomy biliary fistula may result from severing a large unrecognized aberrant duct from the right lobe of the liver that empties into the gallbladder or cystic duct. Recognition of aberrant biliary ducts and identification of the major intrahepatic biliary radicles on cholangiography are emphasized. Two cases are presented. In 1 case percutaneous transhepatic cholangiography (PTC) made the diagnosis. PTC is a safe, accurate method for evaluating postcholecystectomy biliary fistula.