development of a biloma and/or bile peritonitis. If distal bile duct obstruction is present from overlooked common bile duct (CBD) stones or stricture, the leak will be aggravated (Figs. 4.8 and 4.9). Hepatobil-iary scintigraphy is useful in the evaluation of a suspected biliary leak and has the advantage of being noninvasive . The site of leakage and the presence of retained stones or distal strictures can be more definitively identified by endoscopic retrograde cholangiopancreato-graphy (ERCP). In uncomplicated cases of leakage from the cystic duct remnant, treatment with an endoscopically placed biliary stent is usually successful.
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