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Bile Duct Leaks

A bile duct leak occurs when a bile duct is cut or breaks open, spilling bile into the abdomen. Bile is created in the liver and used by the body to help digest fat. After bile has done its job, it’s stored in an organ called the gallbladder. There are three ducts that carry bile to the small intestine. Bile ducts can leak as a complication of certain surgeries. Leaks can also come from high impact hits to the abdomen that may be caused by events like car accidents. When bile leaks into the abdomen, it can cause pain and lead to infection.

Symptoms

Common signs of a bile duct leak include:

  • Bad abdominal pain, particularly in the upper right part of the stomach. This is where the liver, gallbladder, and small intestine are.
  • Nausea and vomiting
  • Fever and/or chills
  • This condition is yellowing in the whites of the eyes or a yellow tinge to the skin. Jaundice can occur in adults when the bile ducts aren’t working properly.

Causes & Risk Factors

The main cause of a bile duct leak is surgery involving the liver or gallbladder. A bile duct leak can also occur due to a traumatic injury to the abdomen.

Risk factors for bile duct leaks include:

  • Inexperienced surgeons
  • Having thin bile ducts
  • Sex – males are more likely to experience a bile duct leak after liver surgery
  • Diabetes
  • Getting certain parts of the liver removed
  • Receiving a blood transfusion during surgery
  • Losing blood during surgery

Diagnosis & Complications

Your doctor will use your medical history, physical exam findings, and certain tests to confirm a diagnosis of bile duct leaks. Laboratory tests will look at proteins in the liver and see if their levels are normal or abnormal. A hepatobiliary (HIDA) scan allows a doctor to see where bile is going in your body. In order to do a HIDA scan, a safe radioactive substance is injected into your arm. Pictures are taken with a camera that can detect radioactive material. As the substance makes its way from the liver to the small intestine, a doctor will be able to see if any bile is leaking. Lastly, a doctor may opt for taking a sample of fluid from your abdomen. The presence of bile in any abdominal fluid shows that bile ducts are leaking.

While bile duct leak complications can be serious, they are highly treatable, especially with a team of experienced medical providers.

Complications can include:

  • Abscess – An accumulation of pus within tissues of the body. It can lead to infection.
  • Biloma – Pool of bile in the abdomen.
  • Infection – Often, the place where the bile duct was cut can become infected. The bile itself also irritates the abdominal tissues, and that can lead to infection over time.
  • Sepsis – Occurs when bacteria from a localised infection gets into the bloodstream. Sepsis can lead to organ failure. It can be fatal if not treated quickly.
  • Bile duct stricture – Occurs when one or more bile ducts gets smaller.

Treatment & Management

The standard treatment for bile duct leaks is called an endoscopic retrograde cholangiopancreatography (ERCP). Using an x-ray, a doctor puts an endoscope – a flexible tube- through the mouth down into the abdomen. Using a dye that allows them to see the bile ducts, the doctor uses the endoscope to place a stent – a small tube- to stop the bile duct leak. The procedure is done while patients are sedated. It is fast and doesn’t require a long hospital stay.

 
 
 

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