Bile Leak

Bile leak refers to the abnormal leakage of bile from the bile ducts into the abdominal cavity. It typically occurs as a complication following surgical or traumatic injury to the biliary system. Left untreated, it can cause peritonitis, abscess formation, or sepsis.

Causes of Bile Leak

Surgical Causes

• Cholecystectomy (most common): Damage to the bile ducts during gallbladder removal.
• Biliary reconstruction or liver transplant surgeries.

Traumatic Causes:

• Abdominal trauma causing bile duct injury.

Other Causes

• Spontaneous rupture of the bile duct due to gallstones or infections.
• Leakage from bile duct strictures or post-ERCP complications.

Symptoms of Bile Leak

• Abdominal Pain: Often localized in the upper right quadrant.
• Jaundice: Yellowing of the skin and eyes due to bile accumulation.
• Fever and Chills: Indicative of infection or peritonitis.
• Bile in Drainage: Noticed post-surgery when surgical drains are in place.
• Nausea and Vomiting.

Treatment Options

Conservative Management (for small leaks):

• Observation: In stable patients, small leaks may seal spontaneously.
• Drains: Placement of surgical drains to remove bile and reduce infection risk.

Endoscopic Management:

• Endoscopic Retrograde Cholangiopancreatography (ERCP): Biliary Stent Placement, Sphincterotomy