Endoscopic Interventions in Bile Leak Post-laparoscopic Hydatid Cyst Drainage: Techniques, Challenges, and Outcomes

Introduction: The liver is the organ most commonly affected by Hydatid disease and is involved in up to 70% of cases. Bile leak after surgery can occur in between 13 and 26% of cases.

Surgical management of bile leak is associated with high morbidity and mortality. Biliary endoscopic procedures have become the treatment of choice for management of bile leak.

Case report: A 58-year-old female case of large hydatid cyst within right lobe of liver underwent laparoscopic cyst excision with omental covering + cholecystectomy; during procedure all the daughter cysts and scolices were sucked out with a 10 mm suction cannula. It was irrigated with a scolicidal agent.

The cyst wall is excised along with gall bladder. Small bile leak identified from the remnant site and was sutured with 2–0 PDS. Bilious fluid noted in drain around 600 mL daily for 3 days. Patient underwent endoscopic retrograde cholangiopancreatography (ERCP); cholangiogram showed thin common bile duct (CBD) with bile leak from right anterior hepatic duct and cavity leak (Strasberg classification A). CBD stenting done to decompress biliary system. Post-ERCP drain output decreased.

Figure 1

Conclusions: Endoscopic drainage of a bile leak following laparoscopic surgery is a minimally invasive procedure aimed at managing complications such as bile leaks that may occur after abdominal surgeries. After the endoscopic drainage procedure, patients may require ongoing monitoring and follow-up appointments to ensure proper healing, manage any potential recurrence, and address any complications that might arise.

Publication History

Article published online:
22 April 2024