Etiology, Diagnosis, and Management of Bilomas: A Current Update

Tech Vasc Interv Radiol. 2015 Dec;18(4):236-43. doi: 10.1053/j.tvir.2015.07.007. Epub 2015 Jul 15.

Abstract

A biloma is a well-demarcated collection of bile outside the biliary tree. Traumatic and iatrogenic injuries, most commonly secondary to cholecystectomy, are the usual causes. Although bilomas are relatively uncommon, this pathologic entity may lead to significant morbidity and mortality if not promptly diagnosed and properly managed. As clinical signs and symptoms of bilomas are often nonspecific and laboratory values may be unremarkable, imaging modalities including ultrasound, computed tomography, magnetic resonance imaging, and hepatobiliary cholescintigraphy play a crucial role in the diagnosis of this condition. It is paramount that interventional radiologists not only be well versed in the management of bilomas but also be knowledgeable in the diagnosis as well as key imaging findings that dictate the interventional management. The purpose of this article is to review the etiology, pathophysiology, and clinical presentation of bilomas to primarily focus on the relevant multimodal imaging findings and the minimally invasive management options.

Keywords: biliary leak; biloma; cholecystectomy complications.

Publication types

  • Review

MeSH terms

  • Adult
  • Bile / metabolism*
  • Biliary Tract Diseases / diagnosis*
  • Biliary Tract Diseases / etiology
  • Biliary Tract Diseases / metabolism
  • Biliary Tract Diseases / therapy*
  • Cholangiopancreatography, Endoscopic Retrograde* / adverse effects
  • Cholecystectomy, Laparoscopic / adverse effects
  • Diagnostic Imaging / methods*
  • Drainage
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Predictive Value of Tests
  • Radiography, Interventional / adverse effects
  • Radiography, Interventional / methods*
  • Risk Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Color