Digestive Disease Interventions 2022; 06(03): 219-231
DOI: 10.1055/s-0042-1753462
Review Article

Biliary Leaks and Bilomas: Etiology, Diagnosis, and Management Techniques

1   The Johns Hopkins University School of Medicine, Baltimore, Maryland
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2   Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
2   Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Funding This study was not supported by any funding.

Abstract

Biliary leaks and bilomas are significant complications that arise more commonly from iatrogenic or traumatic bile duct injury. These are increasingly occurring primarily due to the growing number of laparoscopic cholecystectomies performed. Diagnosis can be challenging because of nonspecific patient symptoms, but early recognition and treatment is crucial for improving patient outcomes. Detection of biliary leaks involves a strong clinical suspicion and multimodal imaging studies, including magnetic resonance cholangiopancreatography, cholescintigraphy, endoscopic retrograde cholangiopancreatography, or percutaneous transhepatic cholangiography. Definitive treatment most often requires the endoscopic placement of biliary stents to decrease pressure in the biliary system and the placement of a percutaneous drain for drainage if a biloma is found. However, biliary leaks are heterogeneous in their severity and location, and some are refractory to the standard approach. In such cases, novel and minimally invasive techniques, rather than surgical procedures, have been described for the treatment of biliary leaks. Diagnosis and management require a multidisciplinary approach by diagnostic radiologists, interventional radiologists, gastroenterologists, and surgeons.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. This study was exempted from institutional review board approval.


Informed Consent

For this type of study, informed consent is not required.


Consent for Publication

For this type of study, consent for publication is not required.




Publication History

Received: 25 April 2022

Accepted: 03 June 2022

Article published online:
11 July 2022

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