Leakage in bile duct can occur as a result of postoperative complication after removal of gall bladder or after liver transplantation. Injury to bile duct and the biliary system as a whole can also give rise to bile leak. Leakage occurs as a result of a small tear or a hole anywhere in the bile duct.
Bile is a thick fluid which is produced by the liver. It is used to digest fat from the food that you eat. Bile is stored in gallbladder. Bile duct is a long tube which carries bile from the gallbladder to the duodenum, first part of small intestine.Bile duct together with gallbladder constitutes biliary system.
What Causes Leak In Bile Duct?
With advancement of surgical techniques there is an increase in hepatobiliary surgery in last ten to fifteen years. This may include removal of gallbladder with the help of laproscope, liver transplantation surgery etc. However, with it there is rise in post operative complications too such as that of leakage of bile from the bile duct.
- One of the common reasons for leakage of bile after biliary surgery is slippage of ligature that is tied at the anastomotic site.
- Other cause can be leakage from an accessory bile duct.
- Damage to the bile duct at the time of surgery.
- Following are certain surgeries and invasive procedures that can cause leakage in bile duct as their complication: Laproscopic or open cholecystectomy, liver transplant, biopsy of liver, percutaneous transhepatic cholangiography.
- A cancerous growth in the bile duct or a benign growth in it is also a reason for bile leakage.
- Besides a blunt or penetrating injury on the abdomen can also cause injury to the bile duct and leakage of bile from it.
Symptoms Of Leaking Bile Duct
The bile leaks directly in the abdominal cavity from the bile duct. This can cause pain, infection and inflammation in the abdomen. The most characteristic symptoms of bile duct leakage are given below.
- Severe pain in abdomen: normally if the bile leakage is postoperative or from a blunt abdominal injury, there is mild to moderate pain in abdomen, or in some cases there is no pain at all. But if bile leakage and collection in abdomen is after an acute inflammation and infection of gallbladder, there is severe pain in abdomen leading to a condition called peritonitis.
- Nausea: it is common in any liver apathy.
- Vomiting: The body is trying to get rid of toxic waste material from the gastrointestinal system in the form of vomiting.
- Fever: due to peritonitis in the abdomen, patient will have high degree fever.
- Jaundice: yellowing of skin and eyes is common in bile duct leakage.
- Abdominal distension: is present due to with peritonitis.
- Pale stool and skin itching are other two important symptoms that may appear after jaundice has set in.
Treatment For Bile Duct Leakage
Before beginning the treatment, the physician tries to locate bile duct leakage.
- With medical and surgical history and other diagnostic tests such as abdominal sonography, CT scan of abdomen, biliary scan and an ERCP, the physician may be able to conclude leakage of bile.
- A tube is placed as a temporary stent in the bile duct if there is leakage from the duct. The procedure is done with ERCP, it is an endoscopic procedure.
- The physician will also give antibiotics to the patient to prevent infection that may occur in the abdominal cavity as a consequence of bile leakage.
- In some cases, surgery may be necessary to repair the damaged bile duct.