Bilioma secondary to choledocholithiasis

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Biliary Tract Diseases
• Surgical Case Reports

Background:

• Biliomas, collections of bile, are uncommon complications in hepatobiliary surgery.
• Choledocholithiasis, gallstones in the common bile duct, can lead to various biliary complications.
• Leaks from the bile duct, particularly the infraduodenal segment, are infrequent but serious.

Observation:

• A patient presented with a bilioma attributed to a large stone obstructing the common bile duct.
• The stone caused a significant leak from the infraduodenal portion of the bile duct.
• Imaging and clinical presentation confirmed the bilioma and its origin.

Findings:

• Choledochotomy (surgical incision into the common bile duct) was performed for stone extraction.
• The large common bile duct stone was successfully removed.
• T-tube drainage of the bile duct was implemented to manage bile flow and facilitate healing.
• The bilioma was evacuated, resolving the bile collection.

Implications:

• This case highlights that choledocholithiasis can cause rare complications like bile duct leaks and subsequent biliomas.
• Successful management involves prompt diagnosis and surgical intervention, including stone removal and biliary drainage.
• The reported treatment approach (choledochotomy, stone extraction, T-tube drainage, bilioma evacuation) is effective for this rare presentation.
• Further research into the specific mechanisms of bile duct leaks secondary to choledocholithiasis may be warranted.