Gangrenous Laparoscopic Cholecystectomy With Compound Complications Leading to Multiple Hospitalizations:

A Complex Case Presentation

Authors

DOI:

https://doi.org/10.46570/utjms-2026-629

Keywords:

Biloma, subcapsular hematoma, lap chole complications, improving outcomes, persistant bile leak

Abstract

Laparoscopic cholecystectomy is a common procedure in general surgery but can lead to complications, ranging from minor bile leaks to more rare and serious complications. In this article, we present a complex case involving a biloma resulting from injury to the accessory bile duct during laparoscopic cholecystectomy. This rare complication was further complicated by a residual phlegmon turned abscess, subacute-subcapsular hematoma, and persistent bile duct leak. To our knowledge, no other case with this combination of complications has been reported. We aim to describe the case and discuss preventive measures that can be taken to reduce the incidence of these complications. This case highlights the importance of careful surgical technique and postoperative monitoring in preventing complications after laparoscopic cholecystectomy.

References

Peters, J.H., et al., Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients. Ann Surg, 1991. 213(1): p. 3-12.

Lim, D.Z., et al., Retroperitoneal bile leak after laparoscopic cholecystectomy. BMJ Case Rep, 2018. 2018.

Ahmad, F., et al., An algorithm for the management of bile leak following laparoscopic cholecystectomy. Ann R Coll Surg Engl, 2007. 89(1): p. 51-6.

Hassani, K.I., et al., A rare case of hepatic sub capsular biloma after open cholecystectomy: a case report. Cases J, 2009. 2: p. 7836.

Prachayakul, V. and P. Aswakul, Successful endoscopic treatment of iatrogenic biloma as a complication of endosonography-guided hepaticogastrostomy: The first case report. J Interv Gastroenterol, 2012. 2(4): p. 202-204.

Gilsdorf, J.R., et al., Radionuclide evaluation of bile leakage and the use of subhepatic drains after cholecystectomy. Am J Surg, 1986. 151(2): p. 259-62.

Way, L.W., et al., Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg, 2003. 237(4): p. 460-9.

Babel, N., et al., Iatrogenic bile duct injury associated with anomalies of the right hepatic sectoral ducts: a misunderstood and underappreciated problem. HPB Surg, 2009. 2009: p. 153269.

Montalvo-Jave, E.E., et al., Strasberg's Critical View: Strategy for a Safe Laparoscopic Cholecystectomy. Euroasian J Hepatogastroenterol, 2022. 12(1): p. 40-44.

Vettoretto, N., et al., Critical view of safety during laparoscopic cholecystectomy. JSLS, 2011. 15(3): p. 322-5.

Balfour, J. and A. Ewing, Hepatic Biloma, in StatPearls. 2023: Treasure Island (FL).

Lee, C.M., L. Stewart, and L.W. Way, Postcholecystectomy abdominal bile collections. Arch Surg, 2000. 135(5): p. 538-42; discussion 542-4.

Shankar, S., et al., Diagnosis and treatment of intrahepatic biloma complicating radiofrequency ablation of hepatic metastases. AJR Am J Roentgenol, 2003. 181(2): p. 475-7.

Vazquez, J.L., et al., Evaluation and treatment of intraabdominal bilomas. AJR Am J Roentgenol, 1985. 144(5): p. 933-8.

Shami, V.M., et al., EUS-guided drainage of bilomas: a new alternative? Gastrointest Endosc, 2008. 67(1): p. 136-40.

Minhas, S., Minhas, A., Malik, M., & Sumanam, P., Large subcapsular hematoma of the liver due to faja corset: a rare case report. Egyptian Liver Journal, 2020. 10(1): p. 1-5.

Arya, R., et al., Large Hepatic Subcapsular Hematoma Following Endoscopic Retrograde Cholangiopancreatography: A Case Report. Cureus, 2022. 14(2): p. e21920.

Cover of Translation: The University of Toledo Journal of Medical Sciences, Volume 16, Issue 1 (2026). The cover features a minimalist blue and white design with the University of Toledo College of Medicine and Life Sciences logo in the upper right, a DNA double helix, and hexagonal scientific icons representing the lungs, cardiovascular system, brain, infectious disease, medications, patient care, and medical monitoring.

Downloads

Published

2026-07-24

How to Cite

1.
Mouawad M, Mouawad J, Colquitt J, Lipka J, Dheendsa A. Gangrenous Laparoscopic Cholecystectomy With Compound Complications Leading to Multiple Hospitalizations:: A Complex Case Presentation. Translation [Internet]. 2026 Jul. 24 [cited 2026 Jul. 26];16(1). Available from: https://openjournals.utoledo.edu/index.php/translation/article/view/629

Issue

Vol. 16 No. 1 (2026): Volume 16 (2026)

Section

Case Reports

License

Copyright (c) 2026 Maroutcha Mouawad, Johnny Mouawad, James Colquitt, John Lipka, Aaphtaab Dheendsa (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).