Ultrasound guided Percutaneous Catheter drainage of Biloma Complicating Laparoscopic Cholecystectomy.

Abstract

Laparoscopic cholecystectomy is the 'gold-standard' of care in the management of gallbladder stones. It has combined advantages of cosmetic surgery, shorter hospital stay, and over-all favourable cost analysis. Complications though infrequent have been recorded. Managing complications following Laparoscopic procedures could pose a challenge in new centres commencing this approach to surgery. This is a report of a 40year old woman with 2 years history of periodic right upper abdominal pain who had laparoscopic cholecystectomy at the Lagos State University Teaching Hospital, Ikeja, Lagos in July 2015 and was discharged home after a brief episode of post-op fever. She was readmitted 3 weeks later with worsening complaints of abdominal distension, fever and Jaundice. At this stage Ultrasound and CT scan confirmed a large, encapsulated cystic mass emanating from the region of the right lobe of the Liver. A diagnosis of Post Cholecystectomy Biloma was made and she underwent Ultrasound guided per cutaneous drainage which yielded 9 litres of bilious fluid over 3 days. Following this intervention she had prompt recovery and was discharged to outpatient clinic. This report underscores the importance of adequate preparations including use of interventionary methods to solve problems complicating laparoscopic surgery.

Key Words: Biloma, Ultrasound, Percutaneous, Laparoscopic Cholecystectomy