Duct of Luschka Bile Leak With Formation of Biloma Post-Cholecystectomy: A Case Study

A rare complication of laparoscopic cholecystectomy is a biloma, which usually develops as a result of the dissection of non-visible, abnormal ducts of Luschka. This anatomical variation in the bile ducts was initially overlooked within the biliary tree. While it generally holds minimal clinical significance, it may occasionally lead to bile leakage following cholecystectomy. In most cases, this complication is self-limiting and resolves without the need for further intervention. We present a case in which a patient developed a post-cholecystectomy biloma, which formed as a result of a bile leak from the ducts of Luschka. The initial workup included a hepatobiliary iminodiacetic acid (HIDA) scan, also called cholescintigraphy or hepatobiliary scintigraphy, which was used to determine and confirm the source of the leak. Computed tomography (CT) of the abdomen revealed fluid accumulation around the liver and in the cystic duct, as well as fluid collection near the surgical site, which suggests the possibility of an abscess. Management of bile leaks usually involves nonsurgical interventions like endoscopic biliary stent placement. When bilomas are present, treatment typically involves percutaneous drainage, as in this case. However, if conservative management fails, surgical intervention, such as exploratory laparotomy, may become necessary. This report further helps to understand the clinical significance of hepatic bile duct variation and complications of laparoscopic cholecystectomy.