Bile duct leakage after laparoscopic cholecystectomy diagnosed by radioisotopic scanning

Laparoscopic cholecystectomy is fast becoming the procedure of choice for removal of the gallbladder. It offers advantages over traditional cholecystectomy with shorter hospital stays, less postoperative pain, and lowered hospital costs. Laparoscopic cholecystectomy has been shown to be a safe procedure when performed by experienced surgeons, but a higher incidence of injury to the bile duct has been noted. Nuclear scintigraphy offers a noninvasive method for the diagnosis of traumatic injury to the bile duct. A case is presented in which a patient developed a major bile duct leak after undergoing an apparent successful laparoscopic cholecystectomy. The complication was promptly diagnosed through the use of nuclear scintigraphy. Radioisotopic scanning should be considered when evaluating patients who manifest abdominal pain after laparoscopic cholecystectomy.