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Such patients usually present with bilioptysis (presence of bile in sputum), persistent cough, chest infections, or respiratory distress due to pleural effusion. Bilioptysis is the pathognomonic clinical feature of BBF. [1] Extensive ascites may accumulate, especially in the setting of sterile bile leakage, which is often asymptomatic in nature.
A hepatoportoenterostomy or Kasai portoenterostomy is a surgical treatment performed on infants with Type IVb choledochal cyst and biliary atresia to allow for bile drainage. In these infants, the bile is not able to drain normally from the small bile ducts within the liver into the larger bile ducts that connect to the gall bladder and small ...
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.
Other procedures associated with ERCP include the trawling of the common bile duct with a basket or balloon to remove gallstones and the insertion of a plastic stent to assist the drainage of bile. [11] Also, the pancreatic duct can be cannulated and stents be inserted. The pancreatic duct requires visualisation in cases of pancreatitis.
It also has better endoscopic access to the biliary tree and more physiologic bile drainage. [8] CDD is used in the treatment of biliary obstruction caused by various factors shown below or when alternative treatment options were not accessible. Other less common indications include operative injuries, or chronic dilation of the CBD. [6]
A surgically created passage between the common bile duct and the jejunum in a procedure called a choledochojejunostomy, can be carried out to relieve the symptoms of biliary obstruction as well as allows the bile duct to drain. [5] In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.
Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage , first performed by American surgeon, Dr. John Stough Bobbs , in 1867.
Considering that biloma is a rare complication, most studies on successful treatment are derived from case reports. 150 cases of biloma have been reported and treated. [10] Radiologically guided percutaneous drainage is also a successful treatment option. However, in the result of a failed drainage of biloma, surgery would be the next option.