Hepatic subcapsular biloma: a postoperative complication following biliary surgery

Abstract

A rarely reported postoperative complication following biliary surgery,and to discuss its possible mechanism.This article summarizes I reported HSB case that developed after laparoscopic cholecystectomy in our department and 9 other cases reported in literature.HSB occurred most frequently after simple cholecystectomy in addition to post operative bile duct exploration with cholecystectomy or endoscopic retrograde cholangiopancreatography.The main clinical presentation of HSB was paroxysmal colic in the upper abdomen early in the postoperative period,which could be induced after a meal.Imaging revealed subcapsular hepatic fluid collection,and successful treatment involved placement of a percutaneous drain in the biloma.The mechanism of HSB still needs to be clarified even though it is a rarely reported postoperative complication following biliary surgery.We hypothesize,after analyzing these 10 cases,that sphincter of Oddi dysfunction after biliary surgery and the subsequent persistence of high biliary system pressure may be the root cause of HSB formation.More awareness should be paid to the changes of the sphincter's motility after biliary surgery and its related complications (biliary colic,HSB etc.). Key words: Cholestasis; Cholecystectomy, laparoscopic; Postoperative complications