Not only is radioscintigraphy more sensitive for detecting bile leaks, it is also more specific. These collections were drained percutaneously. The early post-op course was apparently similar in those with and without complications with patients complaining of nausea and pain. Iatrogenic leaks may arise from damage of biliary radicles during dissection of the gallbladder, division of an accessory bile duct, dislodgement of a loosely placed clip or ligature from the cystic duct stump or injury to the hepatic duct or common bile duct. The usual radioscintigraphic findings of a biliary leak are normal liver function and radioactivity outside the biliary tract and bowel.
Perihepatic collections are the most common and usually resolve spontaneously.
Normally the small bowel is visualised unless all the bile excreted by the liver is being extravasated. Bile leakage into the peritoneal space results in biliary ascites, a serious situation requiring prompt drainage. In some cases abnormal activity identified in the right upper quadrant of the abdomen is difficult to differentiate between small bowel and biliary leak. Very small leaks or slow leaks may require extra delayed images. Fortunately, radioactivity in abnormal bile collections persist even after liver parenchyma and biliary tract are no longer visible, further aiding in their recognition.