Minimally Invasive Management of Post Hepatectomy Localized Bile Leak

Abstract
Background: Bilomas (localized bile leak) are localized post-operative collections of bile. Bile leakage is a common complication after hepatectomy with an occurrence rate of 2.9%-17%. Bile leak is always correlated to increased mor-bidity and mortality due to risk of serious biliary infection. Previously, biloma usually required reoperation. Yet surgical solution for bile leakage usually increases the incidence of patient morbidity and mortality especially in early post-operative period.
Aim of Study: The purpose of this study is evaluate non-surgical minimal invasive strategies as an effective choice in management of biloma (localized bile leak) and these include different strategies as minimally invasive US or CT guided percutaneous drainage with or without ERCP.
Patients and Methods: 20 patients were enrolled in our descriptive study (13 males, 7 females; mean age 49.40±9.30 years; range, 30 to 62 years) with biliary collections after open hepatectomy non of them had biliary reconstruction were treated using non-surgical methods between October 2017 and March 2019 at Al-Demerdash Hospital and Ain Shams University Specialized Hospitals and they were fol-lowed-up for at least 3 month. Percutaneous drainage using a 10Fr drainage catheter using US or CT guidance with/without (ERCP) were performed for management of those collections.
Results: Minimally invasive intervention could be suc-cessfully applied in all 20 cases. In all the cases, a pigtail was inserted for drainage, 17 cases (85%) were successfully drained and 3 cases (15%) weren't drained adequately due to extensive septations and they needed surgical intervention for drainage.
Conclusion: Non surgical (minimal invasive) management is an effective way in treating biloma (localized bile leak).