Management of Traumatic Bile Duct Injury after Complex Liver Injury

Abstract

          Bile duct injuries from blunt abdominal trauma are rare, and bile leak after a liver injury is uncommon, especially in complex liver injury. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and biliary stent insertion effectively treats bile leaks after liver injury. However, ERCP is not always successful, resulting in bilious ascites. We report a case with persistent bile leak after a complex liver injury successfully treated by ERCP and subsequently percutaneous drainage to internal biliary stent placement and intraperitoneal bile drainage.