Endoscopy 2004; 36(12): 1115-1118
DOI: 10.1055/s-2004-826047
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Bile Leakage and Resultant Bile Peritonitis During or After Diagnostic Laparoscopy: An Unpredictable Event

R.  Orlando1 , F.  Lirussi1
  • 1Department of Medical and Surgical Sciences, University of Padua, Padua, Italy
Further Information

Publication History

Submitted 5 April 2004

Accepted after Revision 2 August 2004

Publication Date:
01 December 2004 (online)

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Bile peritonitis secondary to bile leakage is a rare complication of laparoscopy-guided liver biopsy. We report two cases of bile peritonitis occurring, respectively, during and 6 days after liver biopsy in patients with an initial diagnosis of intrahepatic cholestasis associated with chronic pancreatitis. In both cases, bile leakage was first managed by compression with a palpating probe and, at onset or worsening of symptoms, by suture during laparotomy. However, while the first patient progressed uneventfully during the postoperative period, the second died 13 days after laparotomy. In the latter patient, bile leakage was associated with bleeding from the biopsy site with consequently diminished peritoneal irritation and delayed onset of symptoms. In this patient, pancreatic carcinoma, of which evidence was found at autopsy, may also have contributed to the fatal outcome. In conclusion, bile leakage and secondary peritonitis may also occur in the absence of dilation of the biliary tree and may be fatal, especially if not recognized and treated early.

References

F. Lirussi, M. D.

Department of Medical and Surgical Sciences · University of Padua

Via Giustiniani 2 · 35128 Padua · Italy

Fax: +39-49-8212151

Email: flavio.lirussi@unipd.it