Various Presentations of Postcholecystectomy Bile Leak Diagnosed By Scintigraphy

Abstract

Hepatobiliary scintigraphy is an established method for the diagnosis of a bile leak from the biliary system. A bile leak should be considered in any patient after cholecystectomy who has unexplained abdominal pain after operation. Three patients with bile leak diagnosed by scintigraphy are described, one of whom had an unusual pattern of hepatic subcapsular collection of the bile. The second patient had a bile leak through the postsurgical drainage tube, whereas the third patient had a more typical pattern of leakage into the peritoneal cavity.

Bile leaks from the duct of Luschka (subvesical duct): a review

“…However, it provides suboptimal anatomic detail. A subvesical duct injury will be shown as extravasation of radionuclide from the gallbladder fossa [16]. This is the most common initial study used to detect a bile leak.…”

Hepatic Subcapsular Hematoma Secondary to Intrahepatic Pseudoaneurysm Following Cholecystectomy

“…This is also 1 of the known complications of cholecystectomy and may mimic a hematoma on imaging. Nevertheless, content in the space can be confirmed by percutaneous needle aspiration or scintigraphy [13]. Because we surgically drained the subcapsular lesion, however, it was clear that it was a hematoma.…”

Bronchobiliary Fistula Detected With Hepatobiliary Scintigraphy

“…[1][2][3][4][5][6][7][8] Serial images (1 min/frame for 29 frames) (A) and a static image at 30 minutes (B), all in the anterior position, showed minimal leakage of tracer. Late imaging (2 hours) (C) demonstrated tracer accumulation at both sides of the diaphragm (arrows), which increased over time (4 hours) (D).…”