Brief clinical report| Volume 109, ISSUE 6, P796-798, June 1991

Novel approach to iatrogenic bile peritonitis

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      Bile peritonitis after injury to the biliary tree is a serious complication that requires exploratory laparotomy. Our patient had an obstructing ampullary carcinoma, and generalized bile peritonitis developed from attempted percutaneous transhepatic cholangiography. The patient's condition was managed by peritoneal lavage and endoscopic transampullary stenting, with immediate relief of pain and toxicity. Exploratory laparotomy was avoided, and an eventual pylorus-sparing Whipple resection was the definitive treatment. We believe this to be the first report of successful nonoperative treatment of a patient with bile peritonitis with obstructive jaundice.
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        • Kreek MJ
        • Balint JA
        “Skinny needle” cholangiography: results of a pilot study of a voluntary prospective method for gathering risk data on new procedures.
        Gastroenterology. 1980; 78: 598-604
        • Cohn Jr., I
        Bile peritonitis.
        in: 4th ed. Bockus gastroenterology. vol 6. W. B. Saunders Co, Philadelphia1985: 3808-3814
        • Pachter HL
        • Hofstetter SR
        Open and percutaneous paracentesis and lavage for abdominal trauma: a randomized prospective study.
        Arch Surg. 1981; 116: 318-319
        • Pachter HL
        • Hofstetter SR
        Open and percutaneous paracentesis and lavage for abdominal trauma: a randomized prospective study.
        Arch Surg. 1981; 116: 318-319
        • Ackerman NB
        • Sillin LF
        • Suresh K
        Consequences of intraperitoneal bile: bile ascites versus bile peritonitis.
        Am J Surg. 1985; 149: 244-246
        • Harris LF
        • Laney P
        • Kakani PR
        Bile peritonitis.
        Ala Med. 1985; 55: 48-50
        • Means RL
        Bile peritonitis.
        Am Surg. 1964; 30: 583-588
        • MacDonald JA
        Perforation of the gallbladder associated with acute cholecystitis: 8-year review of 20 cases.
        Ann Surg. 1966; 164: 849-852
        • Cain JL
        • Labat JA
        • Cohn Jr., I
        Bile peritonitis in germ-free dogs.
        Gastroenterology. 1967; 53: 600-603
        • Helton WS
        • Dellinger EP
        Biliary tract sepsis.
        in: 2nd ed. New surgical and medical approaches in infectious diseases. vol. 6. Churchill Livingstone Inc, New York1987: 113-132
        • Flemma RJ
        • Flint LM
        • Osterhout S
        • Shingleton WW
        Bacteriologic studies of biliary tract infection.
        Ann Surg. 1967; 166: 563-572
        • Suzuki Y
        • Kobayashi A
        • Ohto M
        • et al.
        Bacteriological study of transhepatically aspirated bile: relation to cholangiographic findings in 295 patients.
        Dig Dis Sci. 1984; 29: 109-115
        • Corbett CR
        • Fyfe NC
        • Nicholls RJ
        • Jackson BT
        Bile peritonitis after removal of T-tubes from the common bile duct.
        Br J Surg. 1986; 73: 641-643
        • Piccinino F
        • Sagnelli E
        • Pasquale G
        • Giusti G
        Complications following percutaneous liver biopsy: a multicentre retrospective study on 68,276 biopsies.
        J Hepatol. 1986; 2: 165-173
        • Schulz TB
        Fine-needle biopsy of the liver complicated with bile peritonitis.
        Acta Med Scand. 1976; 199: 141-142
        • Malberger E
        • Edoute Y
        • Nagler A
        Rare complications after transabdominal fine needle aspiration.
        Am J Gastroenterol. 1984; 79: 458-460
        • Dooley JS
        • Dick R
        • Irving D
        • Olney J
        • Sherlock S
        Relief of bile duct obstruction by the percutaneous transhepatic insertion of an endoprosthesis.
        Clin Radiol. 1981; 32: 163-172
        • Brozinsky S
        • DeSoto-Lapaix F
        • Jimenez FA
        • Ostrowitz A
        Bile emboli: a complication of PTD.
        J Clin Gastroenterol. 1981; 3: 135-137
        • Ferrucci Jr, JT
        • Mueller PR
        • Harbin WP
        Percutaneous transhepatic biliary drainage: technique, results, and applications.
        Radiology. 1980; 135: 1-13
        • Wig JD
        • Chowdhary A
        • Talwar BL
        Perforation of extrahepatic biliary tract producing bile peritonitis.
        Indian J Gastroenterol. 1984; 3: 205-207
        • Rosato EF
        • Berkowitz HD
        • Roberts B
        Bile ascites.
        Surg Gynecol Obstet. 1970; 130: 494-496
        • Taormina V
        • McLean GK
        Chronic bile peritonitis with progressive bile ascites: a complication of percutaneous biliary drainage.
        Cardiovasc Intervent Radiol. 1985; 8: 103-105
        • Taylor JD
        • Carr-Locke DL
        • Fossard DP
        Bile peritonitis and hemobilia after percutaneous liver biopsy: endoscopic retrograde cholangiopancreatography demonstration of bile leak.
        Am J Gastroenterol. 1987; 82: 262-264
        • Nilsson U
        • Evander A
        • Ihse I
        • Lunderquist A
        • Mocibob A
        Percutaneous transhepatic cholangiography and drainage: risks and complications.
        Acta Radiol. 1983; 24: 433-439
        • McCredie JA
        • Driedger AA
        • Anderson RJ
        Primary biliary peritonitis.
        Can J Surg. 1980; 23: 481-482
        • Ruben RA
        • Chopra S
        Bile peritonitis after liver biopsy: nonsurgical management of a patient with an acute abdomen.
        in: A case report with review of the literature. 2nd ed. Am J Gastroenterol. 82. 1987: 265-268