What Is a Postoperative Bile Leak?

A cholecystectomy is done to remove the gallbladder.
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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 25 July 2014
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A postoperative bile leak is a potential complication of cholecystectomy procedures, where the gallbladder is removed. This complication occurs in less than two percent of laparoscopic cholecystectomy cases, and is usually identified after the surgery, when the patient is in recovery. Treatment involves draining the leak and addressing the cause. It can often be accomplished without taking the patient back into surgery, although the patient will need to be placed under sedation for comfort.

Postoperative bile leaks can have a number of causes. One of the most common is a retained bile stone. The stone causes pressure to build up, and can lead to ruptures at the surgical site, allowing bile to leak out. Another potential cause is an injury to the major bile duct. These injuries are often not noticed at the time they occur unless they are significant. In both cases, the patient develops symptoms like nausea, decreased appetite, and abdominal pain after surgery.

A procedure known as endoscopic retrograde cholangiopancreatography can be used to inject tracer dyes to follow the movement of bile visually on a medical imaging study. This procedure will show the bile leak and provide information about the precise location and size. Repair procedures may be possible through the stents inserted during this procedure, allowing a doctor to address the postoperative bile leak quickly and with minimal stress for the patient, before complications like infection develop as a result of the bile leak.

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Developing a postoperative bile leak is not a sign that a surgeon was incompetent or careless. This complication is rare and has been documented in a wide variety of cases, including cases performed by highly experienced and very attentive situations. Care is taken during surgery to avoid any common causes of bile leaks and patients are monitored after surgery to catch leaks early, in the event they develop, as they are a known risk of procedures involving the gallbladder and liver.

Patients who have had cholecystectomy surgeries and notice symptoms like abdominal pain and nausea should report the symptoms as quickly as possible to a nurse or doctor if they are in the hospital. If the patient has been sent home, the surgeon should be called to discuss the symptoms. If there are concerns that the symptoms are indicative of a bile leak, the patient will be asked to undergo some tests to confirm the leak and then will be provided with information about available treatment options.

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Discuss this Article

anon941124
Post 6

My Mom had surgery for a bleeding duodenal ulcer a month ago. Her JP drain continues to fill up with green fluid (bile). Her surgeon said the leak will eventually close with proper nutrition. I am just worried because it is more than a month now and the volume has not decreased.

anon329471
Post 5

Based on my experience, having a bile leak six days post surgery, you will absolutely you are having a major problem as compared to normal recovery.

I have chronic migraines, so I am used to dealing with pain. This was beyond! My son had to call an ambulance and I was hospitalized for two weeks. It took three surgical procedures to get my leak under control as it was "stubborn." Fun times. However, these situations, from what I've been told and read, are extremely rare! I know do many people who have done perfectly well with gallbladder surgery. Just be sure, if you are concerned about something, do not let the medical professionals put you off. Best wishes!

anon328468
Post 4

I had a bile leak. It took a week and lots of tests to find it and that was the longest week of my life! I assume everyone has different experiences, but the pain was worse then a kidney stone, labor, or having three C-sections.

Mine started has a heartburn feeling, but it went around to my back. About a day later, it went to attacks of pain. During the attacks I couldn't breathe and sweat poured. It could last 10 minutes or an hour.

I got three shots of morphine in about 30 minutes and it didn't ease anything. When the HIDA showed the leak, late that night a stent was put in. The next morning, I had surgery again to clean the bile out and had two JP drains put in. I wore one drain for three weeks. I'll need another surgery to remove the stent.

anon254481
Post 3

I had a bile leak after having my gallbladder removed. I was in a severe amount of pain after the surgery, but just thought it was from the surgery. The major site of the pain was around my kidney.

The pain continued for a weeks, so I finally went to the ER. Of course, they couldn't find anything. It took a doctor ordering a scan called a hida scan (sp)?, to notice the leak. I had the ERCP done. Unfortunately, the damage to my body was already so bad that I developed acute hemorrhagic pancreatitis. I had to be opened up completely and cleaned out.

I'm not trying to scare you. Just saying that if you do suddenly notice severe pain after having the surgery, say something immediately.

manykitties2
Post 2

@drtroubles - I had my gallbladder out when I was in my early twenties due to bad diet and a family history of similar issues. I was one of the unlucky ones that had postoperative bile leak and honestly it wasn't that bad. I didn't even know about mine because the doctor spotted it first. I guess they wheeled me right back into surgery and fixed it. It was just a note on my medical chart my mom spotted while snooping about.

I think you'll be fine with your gallbladder surgery. Almost everyone in my family has had it, and besides the issue I had they have all been perfectly fine afterwards. The recovery period is a bit painful, but nothing medication doesn't help.

drtroubles
Post 1

Having your gallbladder removed is a pretty common surgery but I didn't know until recently that a postoperative bile leak was a possibility until I spotted it on a list of complications that could result from this surgery.

Has anyone ever experienced a postoperative bile leak? Did you notice it first or did the doctor?

I am a bit worried about my own upcoming cholecystectomy surgery and worry that I won't be able to discern normal discomforts after surgery from something more serious. I am prepared to be really sore for a while, but am not sure about additional complications. Perhaps I am just worrying a bit too much.

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